Being slightly fat may protect people with type 2 diabetes from an early death, research suggests. Overweight diabetics are 13 per cent less likely to die prematurely than those of a normal weight or those who are obese, scientists found. The findings follow several studies which came to conflicting conclusions on how weight affects the disease.However, many of these were dogged by methodological problems including few patients, short follow-up, or using questionnaires rather than clinic records, the researchers claim.
As part of the new study, they followed 10,568 patients with type 2 diabetes for an average of nearly 11 years. They categorised defined normal weight as having a body mass index (BMI) of 18.5 to 24.9 and defined 'overweight' as having a BMI of 25 to 29.9. While overweight and obese patients had an increased risk of heart attacks and strokes, they were more likely to live longer than normal weight diabetics.
Underweight diabetics had the highest risk of dying during the study, with nearly three times the death rate of normal weight patients. Overweight patients had the best survival, being 13 per cent less likely to die than normal weight or obese diabetics. The researchers, from the University of Hull, said one explanation could be that being overweight protects against frailty and osteoporosis, which can kill.
Alternatively, diabetes in lean people might take and especially lethal form, they suggest. The study's co-author, Dr Pierluigi Costanzo, said: 'It's likely those diabetic patients with normal weight have a more aggressive form of type 2 diabetes compared to those who are overweight and obese.'
He noted the results of the study were at odds with a 2014 study in the New England Journal of Medicine which found no survival advantage with extra pounds. However, that study compared overweight diabetics with people only at the upper end of normal weight. Had it used the full range of the normal weight category – people with a BMI of 18.5 to 24.9 – it is likely the 2014 study would have borne similar results, Dr Constanzo said.
The findings were reported in the Annals of Internal Medicine journal.
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