Could obesity help older people with type 2 diabetes?

September 26, 2013 by Steven Reinberg, Healthday Reporter
Could obesity help older people with type 2 diabetes?
Study found heavier seniors had lower death risk but higher disease risk, with reasons uncertain.

(HealthDay)—Older obese people with type 2 diabetes appear to have a lower death rate than younger people who have diabetes and weigh less, a new study finds.

This so-called " paradox" might mean obesity is actually protective, or type 2 in is somehow different than it is in younger people, the researchers speculate.

Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City, who did not take part in the study, said that "my feeling is that fat is not protective, but the ones who are dying have more bad fat and more aggressive diabetes."

It's not just a matter of weight, but where the weight is and how aggressive the diabetes is that makes the difference, he said.

"What we are seeing nowadays is that young people who develop type 2 diabetes have lots of bad fat," he said. Specifically, that's fat around the middle and around such as the and heart, Zonszein said.

"They come to see me very young, very sick—their livers are full of fat, their hearts are full of fat. And their diabetes is a much more than what we see in elderly people," he said. "It's also much more difficult to treat."

The findings of the new study were due to be presented Wednesday at the annual meeting of the European Association for the Study of Diabetes in Barcelona, Spain.

For the study, British researchers led by Dr. Pierluigi Costanzo, an academic clinical fellow in at the Universities of Hull and York, collected data on more than 12,000 patients with diabetes. Of these about 1,700 had , while the rest had type 2 disease.

Over an average of 10 years of follow-up, 9 percent of the patients had signs of acute coronary syndrome, 7 percent suffered a stroke, 6 percent were hospitalized for heart failure and 34 percent of patients died.

Acute coronary syndrome is an umbrella term for conditions where the blood supplied to the is suddenly blocked, according to the American Heart Association. Heart attack and unstable angina (chest pain) are among these conditions.

The researchers found that episodes of were lowest among people with a normal body weight, but became more common as weight increased and were greatest among those who were obese—49 percent higher than people with a normal weight.

In addition, among obese patients, the risk of was 53 percent higher, and for stroke 25 percent higher compared to normal-weight patients, the study found.

Death rates in those with type 2 diabetes, however, were lower among obese patients compared to normal-weight patients. But this survival benefit was seen only among the oldest patients while the youngest had a higher risk of dying, the researchers reported.

For overweight and obese diabetic patients aged 67 and older, the risk of dying was between 18 and 25 percent lower compared to diabetic patients with a normal weight, the study found.

Although the study found associations between being older and having a lower death risk among diabetes patients, it did not establish a cause-and-effect relationship.

"The notion of an obesity paradox, that some degrees of obesity in some people may confer a favorable rather than unfavorable influence on health outcomes and survival, has been much under scrutiny," said Dr. David Katz, director of the Yale University Prevention Research Center.

There are three crucial considerations to make sense of this, Katz said. "First, the current study is limited to diabetics. One of the most important reasons why obesity is harmful to health is because it causes . Once a study is limited to diabetics, identifying further, independent harms of obesity may be far-fetched," he said.

Second, doctors know that among elderly patients, losing weight is what people should worry about, Katz said.

"It does not surprise me that in older people, obesity does not appear as harmful as in younger people. Older people who are managing to keep weight on are likely eating better and are potentially less isolated and perhaps just more vital than those who are not," he said.

Finally, a recent study showed more deaths among people who were obese for a greater part of their lifetime, Katz said.

"We should recall that obese people in their 70s now did not grow up in a world of epidemic obesity in childhood. Being obese over decades is very different than just gaining weight later in life," he said.

Because the new study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Explore further: Low BMI is a risk factor for CVD in hypertensive patients with diabetes

More information: To learn more about obesity, visit the U.S. National Library of Medicine.

Related Stories

Lap band surgery helps combat diabetes

September 2, 2013

(Medical Xpress)—A trial of gastric band surgery in overweight people with type 2 diabetes has found the surgery resulted in better outcomes for diabetes and weight loss than standard exercise and diet plans.

Thin people get diabetes too

August 5, 2013

Pointing the finger at fat as the major or sole contributor to contracting type 2 diabetes is misleading and wrongly promotes the idea that the condition is entirely self-induced, research at Flinders University has found.

Obesity and asthma: Study finds a link in the genes

July 18, 2013

(Medical Xpress)—Genes linked to chronic inflammation in asthma may be more active in people who are obese, according to new research that uncovers several biological ties between obesity and asthma.

Recommended for you

New blood test may better predict gestational diabetes

April 27, 2017

A new study led by researchers at Brigham and Women's Hospital has found that a single measurement of plasma glycated CD59 (GCD59), a novel biomarker for diabetes, at weeks 24-28 of gestation identified, with high sensitivity ...

Post-biotics may help shield obese from diabetes

April 20, 2017

You've heard of pre-biotics and pro-biotics, but now you'll be hearing a lot more about post-biotics. Researchers at McMaster University have begun to identify how post-biotics, or the by-products of bacteria, lower blood ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.