Higher BMI improves survival in elderly patients with Type 2 diabetes
By Jenny Grice
24 March 2009
Diabet Med 2009; 26: 253–259

MedWire News: A high body mass index (BMI) is associated with improved all-cause and cardiovascular disease survival in hospitalized, elderly patients with Type 2 diabetes, researchers report.

Obesity is associated with increased morbidity and mortality risk in both the general population and in patients with Type 2 diabetes. However, some studies have shown that the opposite is true in hospitalized elderly individuals.

To assess the effect of BMI on total and cardiovascular disease mortality in a very elderly population with Type 2 diabetes, Avraham Weiss (Beilinson Hospital, Petah Tikvah, Israel) and co-workers reviewed the medical records of patients admitted to an acute geriatric ward over the course of 1 year.

Patients were divided into four BMI quartiles (less than 22.1 kg/m2, 22.1 to 24.95 kg/m2, 24.96 to 27.5 kg/m2, and greater than 27.5 kg/m2) and followed-up for nearly 4 years on average. Mortality data were extracted from death certificates.

The authors identified 121 patients with Type 2 diabetes (mean age 79 years) who had more than 6 months of follow-up for analysis.

Presenting the results in the journal Diabetic Medicine, the authors report that 67 (56.4%) patients died from any cause, of whom 30 (24.8%) had a cardiovascular disease-related death.

Those who died from any cause were significantly older (81.6 vs 76.4 years) and had significantly lower BMI values (24.0 vs 27.1) than individuals who survived during the follow-up period.

“Subjects who died of cardiovascular disease causes did not differ by age from others, but they had significantly lower BMI values: 23.7 vs. 25.9 kg/m2,” write the authors.

They found a continuous reduction in total mortality across the four BMI quartiles, with 24 (80%), 19 (63.3%), 15 (48.4%), and 9 (30%) deaths occurring, respectively, in the lowest to highest BMI quartiles. Cardiovascular disease mortality was also significantly lower in the lowest compared with the highest BMI quartile.

The authors found that BMI was inversely associated with all-cause and cardiovascular mortality even after controlling for age, gender, smoking, dyslipidemia, and reason for hospital admission.

They suggest that high BMI is associated with improved survival in hospitalized, elderly patients with Type 2 diabetes.

“Finding the ‘optimal’ BMI for elderly patients with Type 2 diabetes may aid clinicians and other health providers in tailoring the appropriate nutritional and other lifestyle recommendations to this growing population,” the team concludes.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

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