Among diabetes patients, the obese outlive the trim

By Rachael Rettner, MyHealthNewsDaily 

People with Type 2 diabetes who are relatively trim may not live as long as people with the condition who carry extra weight, a new study finds.

In the study, people with diabetes who were of normal weight at the time of their diagnosis were about twice as likely to die from any cause over a 10- to 30-year period than those who were overweight or obese at diagnosis.

The findings held even after the researchers took into account factors that could increase people's risk of dying, such as age, blood pressure, blood fat levels and smoking status.

The results agree with the so-called obesity paradox : the idea that, despite being at a higher risk of many chronic conditions, obese people seem to be protected from dying of certain diseases, such as heart disease.

The researches aren't sure why overweight and obese diabetes patients in the study fared better than normal-weight patients in terms of survival, and they said further research is needed.

It's possible that normal-weight people who develop diabetes have genetic variations that put them at risk for other illnesses, too, said study researcher Mercedes Carnethon, an associate professor of preventive medicine at Northwestern University Feinberg School of Medicine.

"Whatever that genetic change or mutation may be may also increase their likelihood of suffering mortality," Carnethon said.

Carnethon and colleagues analyzed information from five previous studies that included a total of 2,625 people with diabetes, who were followed for nine to 28 years.

Participants were classified as normal weight if their body mass index was between 18.5 and 24.9, and as overweight/obese if their BMI was 25 or greater.

The proportion of adults in the study who were normal weight at the time of their diabetes diagnosis was 12 percent. Over the course of the studies, a total of 449 people died — 178 from heart disease, and 253 from other causes.

The yearly death rate for normal-weight people was 284.8 per 10,000 people, while it was 152.1 deaths per 10,000 among those who were overweight or obese..

There was no difference between the rate of death from heart disease in normal weight and that of overweight/obese individuals, according to the study.

Normal-weight people make up just 5 percent to 15 percent of the diabetic population, Carnethon said. However, because of these people's increased risk of death, doctors should take that population very seriously, Carnethon said.

Older people and those of certain ethic groups, including Asians, are at higher risk for diabetes that occurs at a normal weight, Carnethon said. Cases of normal-weight diabetes are likely to increase as the population ages and diversifies, she said.

Diabetes patients, regardless of weight, are urged to exercise and follow a diet that will help reduce their blood sugar and blood fat levels, Carnethon said. For normal weight people,the goal of these recommendations is not necessarily to lose weight, but rather to help reduce risk factors for disease and death.   

One limitation of the study is that the researchers were not able to measure the study participants' distribution of fat tissue directly. (BMI is a ratio of weight to height.) It could be that some people with a high BMI who are classified as obese actually have a high proportion of lean muscle mass, which is healthier than fat, the researchers said. By contrast, some normal-weight people may have a high percentage of body fat if they have depleted muscle mass.

The study appears in the Aug. 8 issue of the Journal of the American Medical Association.

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Discuss this post

Duh.... Fat protects the body against a lot of things. If it was so bad for us, why do our bodies fight us tooth and nail to KEEP it??

  • 8 votes
Reply#1 - Tue Aug 7, 2012 9:45 PM EDT

I am a diabetic and I find that 12 to 14 hours of sleep a day keeps me felling pretty good and when I am sleeping I'm not eating so my sugar stays pretty level (normal) I hope this helps me live a lot longer. For what I have no idea? I'm 6'1", 185, don't smoke or drink alcohol. I think I've been out side the house for a total of 24 hours all summer. My doctor wants to know if I've always been in such good shape.

    #1.1 - Wed Aug 8, 2012 3:05 AM EDT

    I am a diabetic and I find that 12 to 14 hours of sleep a day keeps me felling pretty good

    That's great Confussed, but most people in the real world actually have lives and commitments that don't allow us to live sloths where we can sleep for 12-14 hours a day. I really don't get all the sympathy for Type II diabetics. This 'disease' is completely self-inflicted, much like being an alcoholic or drug addict and one of the primary reasons why health care costs in this country are the highest in the world.

    Individuals such as this are the primary reason why I'm against any sort of national health care program; because everyone loses any sort of financial incentive to live a healthy lifestyle, and eventually their higher health care costs are passed onto the people that do. Yes I realize that you can say the same regarding people with true pre-existing conditions, but other than that, I don't see any reason why someone why doesn't exercise or refuses to eat healthy should have the same costs as someone who does.

      #1.2 - Wed Aug 8, 2012 6:19 AM EDT

      Not always self-inflicted. Some folks just have bad genes. I had a friend diagnosed with type II diabetes at age 32. He is very trim and active. Swam or ran for an hour every day and is a life-long vegetarian with almost no junk food in his diet. Yet he got type II diabetes.

      • 6 votes
      #1.3 - Wed Aug 8, 2012 6:36 AM EDT

      I really don't get all the sympathy for Type II diabetics. This 'disease' is completely self-inflicted, much like being an alcoholic or drug addict

      I really don't feel that much sympathy toward your position. Tom Marvolo. While a lack of intelligence, like diabetes or a tendency toward addiction, can be based on heredity - being ignorant is completely self-inflicted.

      • 10 votes
      #1.4 - Wed Aug 8, 2012 6:38 AM EDT
      News98Deleted

      Not all diabetes II is self-inflicted. I became diabetic in my 50s, but had gestational diabetes when I was pregnant at 30. After my son was born, the diabetes went away. Gestational diabetes does gives a woman more risk of developing diabetes later in life. Diabetes can be hereditary, but no one else in my family has it.

      Like 'News98', there's no sense in beating yourself up by trying to figure out what caused the disease to happen in the first place. Being obese doesn't help, but maybe I was wrong...maybe fat staves off some diseases.

      I do watch what I eat making sure I eat healthy - lots of vegetables and complex carbs like fruit. I try not to eat so much bread or sugar and mostly chicken and lean meat, but do slip up once in awhile, as I do love french bread and gumdrops. I also get plenty of exercise, since I work at an amusement resort which involves lots of walking, lifting and bending. I currently weigh about 170 after losing quite a bit of weight this summer, which has helped, somewhat, in keeping my blood sugar low. I certainly don't sleep 12-14 hours a day, but do need at least 7 or 8.

      I don't know of many diabetics who are looking for sympathy, just understanding and help.

      • 1 vote
      #1.6 - Wed Aug 8, 2012 7:17 AM EDT

      Tom.Marvolo

      I am a diabetic and I find that 12 to 14 hours of sleep a day keeps me felling pretty good

      That's great Confussed, but most people in the real world actually have lives and commitments that don't allow us to live sloths where we can sleep for 12-14 hours a day. I really don't get all the sympathy for Type II diabetics. This 'disease' is completely self-inflicted, much like being an alcoholic or drug addict and one of the primary reasons why health care costs in this country are the highest in the world.

      Individuals such as this are the primary reason why I'm against any sort of national health care program; because everyone loses any sort of financial incentive to live a healthy lifestyle, and eventually their higher health care costs are passed onto the people that do. Yes I realize that you can say the same regarding people with true pre-existing conditions, but other than that, I don't see any reason why someone why doesn't exercise or refuses to eat healthy should have the same costs as someone who does.

      ----------------------------------

      Thank God we don't have a consensus mindset like you running our country. We'd have mass drifters, homelessness, and far more death in the world thanks to your cynical attitude.

        #1.7 - Wed Aug 8, 2012 12:39 PM EDT
        Reply

        What nonsense-this article is not convincing at all-obese people are prone to all sort of diseases.

          Reply#2 - Tue Aug 7, 2012 9:59 PM EDT

          And we fail at reading comprehension. The article states: "despite being at a higher risk of many chronic conditions, obese people seem to be protected from dying of certain diseases,".

          Maybe this will help, "higher risk" = prone.

          • 5 votes
          #2.1 - Wed Aug 8, 2012 3:33 AM EDT
          Reply

          Not convincing, and encourage people to unhealthy lifestyle that in the end are created more problems, chronic diseases and more spending on treating them.

          • 1 vote
          Reply#3 - Tue Aug 7, 2012 10:23 PM EDT

          So if you get type 2 diabetes, you'd better start eating & packing on the pounds, right?!

            Reply#4 - Tue Aug 7, 2012 11:05 PM EDT

            If this were true, why is it that many with type 2 diabetes return to normal insulin levels after loosing weight and watching their diet? Could it be that many heavier diabetics are taking medications which also help reduce heart attacks, while those less fat might not, simply watching their sugar intake which they find stressful? Could it be that stress from dieting could be resolved with stress reduction techniques instead of encouraging remaining obese? Also, since diabetes can result in other organ damage, why was that info not included for a fuller and fairer understanding.

            • 2 votes
            Reply#5 - Tue Aug 7, 2012 11:09 PM EDT

            Loose as in less tight, lose as in to misplace. Points off for an otherwise well thought out response. Many medications taken over long periods of time can cause organ damage as well, kidneys, liver, etc.

            • 1 vote
            #5.1 - Wed Aug 8, 2012 1:08 AM EDT

            Please note that the association with increased risk of death was for those who were at normal weight at the time of diagnosis. One hypothesis could be that those people who get type II diabetes even though they are at a normal weight have a strong genetic propensity towards the disease and the disease may follow a more aggressive course in these unfortunate people.

            • 1 vote
            #5.2 - Wed Aug 8, 2012 6:41 AM EDT
            Reply

            It obviously is not only about the weight. There are other health determinants besides how much you weigh. What you eat does count. If you live on Twinkies and weigh a svelte 110 lbs, you will not be healthier than if you eat lots of really good food and weigh 150 lbs. There are other factors, and this study brings that fact out. Of course to be your best, you need to strive to be a healthy weight, eat healthy food, live a clean life, exercise, and many other things probably contribute to health besides strictly weight and nothing else.

            • 1 vote
            Reply#6 - Wed Aug 8, 2012 1:14 AM EDT

            Hmmmm ..... I'm 5" 6" and 180 lbs have Type II, gout, mild h'tension, h'cholesterol for 30 yrs. Been struggling with my diet for 20 yrs to get to 170 and never made it. I've spent most of my life around 185-190 ... but NOW I'm heading to Baskin Robins. @60 yrs old ... I need to get to 195 Fast !

            • 2 votes
            Reply#7 - Wed Aug 8, 2012 1:14 AM EDT

            Oh YES, this study must have been FUNDED by Snickers and WRITTEN by Lay's Potato Chips !

              Reply#8 - Wed Aug 8, 2012 1:16 AM EDT

              I'm going to go out on a limb here. Perhaps the trim people THINK they are in shape and don't exercise? Their genetics are keeping them trim but they may not be healthy at all.

              • 6 votes
              Reply#9 - Wed Aug 8, 2012 1:40 AM EDT

              Keep the A1C down and the rest is a cake walk. Statins and COQ10 if the fat is crusing your blood.

              Oh screw it. Drink beer and keep making love to your honey until you die. Tomorrow they will say something different...

              • 4 votes
              Reply#10 - Wed Aug 8, 2012 1:43 AM EDT

              I think it just goes to show that Doctors don't really have a deep understanding of the human body. When in doubt, the medical establishment likes to fall back on "lifestyle" because blaming the illness on the patient is deeply ingrained in Western culture so it's much less likely to be questioned.

              For a hundred years Doctors believed all stomach ulcers were caused by stress (i.e lifestyle) until scientists found the bacteria Helicobacter pylori in 1982.

              • 2 votes
              Reply#11 - Wed Aug 8, 2012 2:14 AM EDT

              Skane: Do you have an M.D. degree? Helicobacter pylori is the main cause of duodenal ulcer, not gastric (stomach).

                #11.1 - Thu Aug 9, 2012 2:41 AM EDT
                Reply

                Oh you people of this study are very seriously in trouble now.

                That New York and Chicago mayors and her highnest queen Meschel obuma are going to cum at ya with the full force of the far lefties and absolute libral donkey party. If you don't have yo check bones and lowor for rib ribs shown - yo surly ova wai't. EN thats they don't like. They like ta tell ya what ya want to eat

                Now you tellen we live longa if ya fat - ! That's easy figun. Iya skinny - ya unemployed and starvin ta death.

                If ya fat I guessen ya a fat liberal on The pres bread line an unemployed.

                • 1 vote
                Reply#12 - Wed Aug 8, 2012 2:59 AM EDT

                ......???......

                I'm not sure what the point of your rambling, incoherent rant was, but I'm quite sure everyone here is now more stupid for having read it. Thanks a bunch. Now go away.

                  #12.1 - Wed Aug 8, 2012 7:46 AM EDT
                  Reply

                  People, Reading 101 again. The article doesn't say to stay fat (yes, I used the f-word) if you develop diabetes. It merely says that people who were fat when they were diagnosed have a smaller chance of dying than those who were regular-sized when they were diagnosed. As with most stories about statistics, this doesn't show a cause/effect relationship -- it only shows a correlation. The researchers admit they have no idea what the correlation is. Maybe the connection is just that fat people carry more weight around -- like the difference if a slim person carried a backpack with a 100 extra pounds everywhere they went. Maybe the fat people work harder at losing weight and exercising to reduce the effects of the disease. Who knows? As for me, I kind of like the posts that say live your life the way you want. Whether it's Baskin-Robbins or making love, just be happy.

                  • 4 votes
                  Reply#13 - Wed Aug 8, 2012 3:09 AM EDT

                  My doctor told me that if i lose weight, my type II diabetes could go away. I wouldn't need to take medicine to control my blood sugar anymore. It appears that he is correct. Keeping the weight off is the challenge.

                  • 3 votes
                  Reply#14 - Wed Aug 8, 2012 5:12 AM EDT

                  More evidence, if more was needed, that the medical authorities really do not know what they are talking about, at least half the time.

                  • 1 vote
                  Reply#15 - Wed Aug 8, 2012 5:14 AM EDT

                  So, it's ok if I devour this entire dozen Tim Horton's donuts?

                    Reply#16 - Wed Aug 8, 2012 5:37 AM EDT

                    Normal-weight people still live longer than obese people, who are prone to other conditions, especially heart disease.

                      Reply#17 - Wed Aug 8, 2012 5:40 AM EDT

                      That's what I always thought but the article says that obese people are protected from heart disease.

                        #17.1 - Wed Aug 8, 2012 5:47 AM EDT

                        Kevin . . apparently your Doc was correct. If you Lose the Weight you won"t need the Meds. Because You are More Likely to be Dead!! And the diabetes will be gone too!

                        • 2 votes
                        #17.2 - Wed Aug 8, 2012 5:58 AM EDT
                        Reply

                        Enough already--just CURE DIABETES and be done with it! It is a horrible death, I saw 6 family and friends cut up and gone blind and deaf, lost feeling in hands and feet! Horrible disease---yet Congress, Drug Companies, Doctors just ignore the simple fact---CURE IT! It is a virus--cure it! This country has cured ONE disease since 1950--thats 1950 folks! POLIO! Thats it and Dr Salk only cured it cause Mrs. Dr Salk got polio! We go to Moon, now Mars, build military, pay tremendous wasted money on Congress salaries and bennies--yet ignore deadly disease cures. Pharms and Drs are making huge salaries on diabetic pills, lottsa money so why cure it? The power people get rich and a 10 year old gets diabetes and take pills. Cure diabetes and enough about it!

                        A Diabetic.

                        • 5 votes
                        Reply#18 - Wed Aug 8, 2012 6:47 AM EDT
                        Reply

                        They really don't know everything about type II diabetes.

                        My father was an athlete, exercised, maintained his weight and ate healthy all of his life yet he has type II diabetes. Thin people are also diagnosed with type II diabetes. I recall there was an article on this site about it.

                        • 1 vote
                        Reply#19 - Wed Aug 8, 2012 6:49 AM EDT
                        News98Deleted

                        Sounds like a call for a Big Mac and large fries with chocolate shake.

                          Reply#21 - Wed Aug 8, 2012 7:53 AM EDT

                          I was struggling to loose weight because of diabetes, but according to this new scientific research, this would really be detrimental to my health. Since fat people are outliving the thin people, now I will have that double bacon cheese burger instead of fruit salad. Who would have thought being fat could be so good!!!!!

                            Reply#22 - Wed Aug 8, 2012 8:14 AM EDT

                            The problem is defining overweight and obese. Overweight is not necessarily obese. Defining overweight by assigning it an arbitrary value to tell who is normal weight is the problem. Each person is different. You definitely have to go by fat % and distribution. Many athletes and body builders have large BMIs.

                              Reply#23 - Wed Aug 8, 2012 12:59 PM EDT

                              This article is misleading,it just confuses people into thinking its okay to be fat..[NOT]

                                Reply#24 - Wed Aug 8, 2012 2:44 PM EDT

                                Most type II diabetics are overweight/obese, but not all. Diabetes will develop in people with a normal body weight if they eat a poor diet – known as “metabolically obese normal weight” and “non-obese diabetic.” The same might be true for mortality among diabetics; lean diabetics eating a significantly worse diet than obese diabetics would be at increased risk for all-cause mortality (). The fact that they have diabetes at a normal body weight might be an indicator of a poor diet.

                                  Reply#25 - Wed Aug 8, 2012 10:04 PM EDT

                                  People with under-active thyroids tend to be overweight. Once this is discovered, they are put on synthetic hormones to replace those the thyroid is not producing. They usually lose the weight. Then, these same people often develop diabetes because the synthetic hormones are known to raise blood sugar.

                                    Reply#26 - Sun Sep 2, 2012 10:28 PM EDT
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