Diabetes in the Absence of Obesity: A Risky Condition
Despite the persistence of the obesity epidemic and its contribution to development of metabolic and cardiovascular diseases, a growing number of studies have described a paradoxically longer survival (the "obesity paradox") among overweight and obese adults with and without chronic diseases.1 Whereas the obesity paradox has previously been observed among adults with chronic kidney disease, heart failure and cancer, a growing number of studies have investigated this question in the setting of diabetes. Whether the obesity paradox is present in diabetes is of particular interest given the importance of obesity in the etiology of diabetes and the development of complications. In this week's issue of Circulation, Zhao and colleagues2 report a U-shaped association between weight status and mortality among adults with diabetes whereby the lowest mortality rates are observed among adults who are overweight or obese. These findings are consistent with some,3,4 but not all,5 prior findings.
- Received October 30, 2014.
- Accepted October 30, 2014.