This site complies with the HONcode standard for trustworthy health information:
verify here.

Rewarding for
you and us
Defeat Diabetes Foundation

Defeat Diabetes
Foundation
150 153rd Ave,
Suite 300
Madeira Beach, FL 33708

Diabetes, Not Obesity, Increases Critical Illness and Death Risk

Posted: Thursday, October 19, 2006

Diabetes is a strong predictor of acute organ failure and early death for obese or non-obese patients alike, eclipsing even obesity without diabetes, according to researchers.

In the absence of diabetes, a patient's body mass index (BMI) did not foretell organ failure or in-hospital death, according to a large prospective cohort study of 15,408 middle-aged adults.

By contrast, diabetics had a threefold higher rate of organ failure over three years from baseline versus non-diabetics, said David Mannino, M.D., of the University of Kentucky here, and colleagues at Emory in Atlanta. Within three years, 5.4% of those with diabetes died, compared with 1.6% of those without diabetes.

Patients in the analysis, ages 44 to 66, came from the Atherosclerosis Risk in Communities study and had originally been studied from 1986 to 1989. Overall, 11.9% of all the participants had diabetes, and not surprisingly those with diabetes were more likely than those without diabetes to have a BMI of 30 or more (52% vs 24% P<0.01).

The prevalence of diabetes rose with increasing BMI, the researchers said. At baseline, participants with a BMI of at least 30 were more likely than those in lower BMI categories to have diabetes (22.4% versus 7.9%, P< 0.01), the researchers said.

However, the investigators noted that BMI levels in themselves did not affect acute organ failure. Of patients with ideal body weight, 0.9% developed acute organ failure. This was virtually the same as 0.8% for overweight and 0.9% for obese subjects.

The major risks factors for acute organ failure included older age, male sex, diabetes, and lower levels of lung function. These, along with smoking, black race, and lower educational level, predicted death within three years, the researchers said. Significantly, within three years, 5.4% of subjects with diabetes died, in contrast with 1.6% of subjects without diabetes.

Among the risk factors, diabetes was one of the strongest independent predictors for acute organ failure, with a threefold increased risk (odds ratio 3.2, 95% CI 2.1 to 4.7), and for all-cause mortality at three years (OR 2.7, CI 2.1 to 3.5).

The results of this large prospective study of middle-aged U.S. adults suggest that the development of acute organ failure followed by death is related more to the presence of diabetes than to an increased BMI, the researchers said in summary.

These results, they added, "bring a new perspective on this still controversial subject of obesity, critical illness, and mortality."

Source: Diabetes In Control: Slynkova, K, et al "The role of body mass index and diabetes in the development of acute organ failure and subsequent mortality in an observational cohort" Critical Care 2006; 9/25.