Longer duration of obesity elevates type 2 diabetes risk among women
Women are more likely to develop type 2 diabetes if they develop obesity earlier in life and at a more rapid pace, according to findings published in Diabetologia.
“Our data indicate the importance of timing of obesity and cumulative exposure to obesity measured by obese-years in relation to diabetes risk in young women,” Juhua Luo, PhD, MS, associate professor in the department of epidemiology and biostatistics at Indiana University School of Public Health, and colleagues wrote. “The results highlight the importance of preventing or delaying the onset of obesity and reducing cumulative exposure to obesity to substantially lower the risk of developing diabetes.”
Luo and colleagues studied data on changes in weight and type 2 diabetes diagnoses across 19 years among 11,192 women who took part in the Australian Longitudinal Study on Women’s Health (mean age, 20.8 years). At baseline and at 3-year intervals, self-reported data provided information on weight, height and diabetes diagnoses.
The researchers created six categories of BMI trajectory based on the data, including those who had normal weight at baseline and either “stable” (13%), “mid-stable” (14%), “low modest increase” (21%) or “rapid increase” (28%), those who had overweight at baseline and a rapid increase (21%) and those who had obesity and a rapid increase (3%).
Type 2 diabetes was diagnosed in 1.5% of the cohort. Type 2 diabetes risk was greater for each BMI trajectory compared with the group with normal weight and stable BMI, with an HR of 10.06 those with obesity and a rapid BMI increase (95% CI, 4.69-21.58), 4.75 for those with overweight and a rapid BMI increase (95% CI, 2.43-9.28), 7.07 for those with obesity at baseline (95% CI, 4.73-10.57) and 2.33 for those with overweight at baseline (2.33; 95% CI, 1.53-3.55).
“The results highlight the importance of overweight or obesity in early adulthood as risk factors for adult diabetes, indicating that weight control starting before early adulthood is critical for reducing type 2 diabetes risk in later life,” the researchers wrote.
Type 2 diabetes risk was also greater for those who did not have obesity at baseline but eventually developed the disease vs. those who did not (HR = 3.01; 95% CI, 2.01-4.5). Additionally, risk for diabetes was 5.88 times greater for those with 30 or more “obese years” vs. those without obesity (HR = 5.88; 95% CI, 3.15-10.97). The risk was 3.01 times greater for those with between 10 and 30 obese years (HR = 3.01; 95% CI, 1.53-5.91) and 2.18 times greater for those with fewer than 10 obese years vs. those without obesity (HR = 2.18; 95% CI, 1.25-3.81). There was a 13% reduction in risk each year obesity was delayed (HR = 0.87; 95% CI, 0.79-0.96).
“Our finding indicates that early-onset obesity may be particularly deleterious for future diabetes risk in women,” the researchers wrote. “These data highlight the need for early diabetes prevention efforts to prevent or delay the onset of obesity. ... We recommend that people self-monitor weight change over time, and that health care providers attend to weight change in addition to static weight as another risk factor for diabetes.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.