Death rates are almost three times higher among Indians with diabetes compared to Indians without diabetes, a 10-year Chennai-based follow-up study published earlier this week in Plos One has claimed. Surprisingly, being underweight was associated with a significantly higher risk of dying.
A paper by R.M. Anjana et al sets out this idea, with proof from a retrospective mortality study from the Chennai Urban Rural Epidemiology Study (CURES), which set out to map the incidence of diabetes in the city from 2001-2003. Of the 2,273 adults from the 10-year follow-up of CURES, the cause of death could be ascertained in 552 individuals out of the 671 who had died.
Dr. Anjana, Vice president, Madras Diabetes Research Foundation (MDRF), explains: “To our knowledge, this is the first study from India to compare mortality rates in a representative population-based cohort of individuals with and without diabetes.”
All individuals with diabetes and one in ten of those without diabetes were followed up for the next 10-15 years to look at the mortality rates.
V.Mohan, director, MDRF, and co-author, says: “Methods to improve diabetes control have definitely improved over the years, but as far as the death rate goes, in the age group 51-70 years, it still remains almost three times higher.”
The researchers were thrown off keel with their findings on body weight though. “The expectation is that overweight people have a greater risk, so we were in for a surprise when we found that underweight people had a higher risk. Maybe they had health conditions because of which they were underweight, but we did realise that a higher BMI actually helped. While gross obesity is undoubtedly harmful, this study shows that small degrees of excessive weight, especially in older people, may not be as bad as was believed earlier. This is a newly-emerging finding worldwide, and needs further study.”
But the good news is that the risk of mortality could be reduced with interventions. Dr. Anjana says, “Coronary heart disease, which contributed 53% of the risk of mortality in those with diabetes, can be reduced if it is diagnosed and detected early and aggressively. Renal disease was another cause of death. Diabetes, which is a significant contributor to mortality, can also be prevented. Even if it is well controlled, it could also reduce the mortality rates. Other important contributors such as physical inactivity, high cholesterol levels, dyslipidemia, smoking and alcohol use and hypertension are also easily modifiable.”
