What Teens Weigh Can Predict Future Diabetes Mortality, Study Finds

The study of teenagers found that the risk of early death from diabetes increased at BMI levels below the cutoff for what is considered "normal" in adults.

A study from Israel finds that a teenager’s body mass index (BMI) could predict the likelihood of dying decades later from diabetes.

What’s alarming, according to the findings, is that the risk of death or complications from diabetes at some future date starts to increase at BMI levels considered normal for many adults.

Researchers from the Sheba Medical Centre evaluated records from 2.3 million teenagers who had their BMI values measured between 1967 and 2010. Values were matched with death records from national registries. A total of 481 deaths from diabetes were found, with a median follow-up of 18.4 years. The average age of death for those who died was 50.6 years.

Teenagers who were already overweight or obese had higher risks for death from diabetes, even after adjusting for other risk factors. The complicating issue here was how one defines “overweight.” The CDC classified adults with a BMI of 18.5 kg/m2 to 24.9 kg/m2 as being in the “normal” range, and those with a BMI of 25 to 29.9 kg/m2 are overweight. Anyone with a BMI of 30 kg/m2 or higher is obese.

But in this new study, researchers found that mortality risk started to increase once BMI reached 22.4 kg/m2. For a teenage girl who is 5 feet, 4 inches tall, that means the risk would increase after 130 pounds, not 145. For a boy who is 5 feet, 10 inches tall, it’s the difference between 156 pounds and 174 pounds.

“The increasing prevalence of overweight and obesity, and of adolescents in the mid- and high-normal range, is likely to account for a large an increasing proportion of (diabetes mellitus) incidence, its related microvascular and macrovascular complications, and (diabetes) mortality,” the authors wrote.

The authors’ warning about the rising risk of diabetes mortality in the population, based on what they were seeing the data from 17-year-olds, was striking: “The estimated population-attributable fraction for (diabetes) mortality was 31.2% for the 1967 to 1977 prevalence of overweight and obesity at age 17, and increased to 52.1% for the 2012 to 2014 prevalence.”

"The increasing prevalence of childhood and adolescent overweight and obesity points to a substantially increased future adult DM burden," they wrote.

Reference

Twig G, Tirosh A, Leiba A, et al. Body mass index at age 17 and diabetes mortality in midlife: a nationwide cohort of 2.3 million adolescents [published online October 12, 2016]. Diabetes. 2016; http://dx.doi.org/10.2337/dc16-1203