Losing weight could prevent or even reverse diabetes, according to the latest research presented today at the 2020 ESC Congress.1
In 2019, around 463 million people worldwide had diabetes, the vast majority (around 90%) of whom had type 2 diabetes.2 Diabetes doubles the risk of coronary heart disease, stroke, and death from cardiovascular disease.3 Obesity is the leading cause of type 2 diabetes, while genetics can also identify people who are more likely to develop the condition.4th
“Because we are born with our genes, it may be possible early in life to determine who has a high chance of developing diabetes in their lifetime,” said lead researcher Professor Brian Ference of Cambridge University, UK, and the University of Milan. Italy. “We conducted this study to see if the combination of inherited risk with current body mass index (BMI) could identify people at the highest risk for diabetes. Prevention efforts could then focus on these people. ”
The study included 445,765 participants from the UK biobank. The mean age was 57.2 years and 54% were women. Inherited diabetes risk was assessed using 6.9 million genes. Height and weight were measured at registration to calculate BMI in kg / m2. The participants were divided into five groups according to their genetic risk for diabetes. They were also divided into five groups based on BMI.
Participants were re-examined up to an average age of 65.2 years. During that time, 31,298 developed type 2 diabetes.
Those in the highest BMI group (average 34.5 kg / m2) had an 11-fold increased risk of diabetes compared to the participants in the lowest BMI group (average 21.7 kg / m2). The highest BMI group had a higher probability of developing diabetes than all other BMI groups, regardless of genetic risk.
“The results show that BMI is a much stronger risk factor for diabetes than genetic predisposition,” said Professor Ference.
The researchers then used statistical methods to estimate whether people with a high BMI would be even more likely to have diabetes if they were overweight for an extended period of time. They found that the duration of an increased BMI had no effect on the risk of diabetes.
Professor Ference said, “This suggests that when people exceed a certain BMI threshold, their chances of diabetes increase and remain at the same high risk no matter how long they have been overweight.”
He noted that the threshold is likely to be different for each person and would be the BMI at which they start developing abnormal blood sugar levels. Professor Ference said: “The results show that most cases of diabetes could be avoided by keeping the BMI below the limit that causes abnormal blood sugar. This means that both BMI and blood sugar should be measured regularly to prevent diabetes. Efforts to lose weight are crucial when a person begins to develop blood sugar problems. ”
“It may also be possible to reverse diabetes by reducing it in the early stages before permanent damage occurs,” said Professor Ference.
References and Notes
1Abstract title: Integration of the effect of BMI and polygenic scores to estimate lifetime risk and determine optimal treatment goals to prevent or reverse diabetes.
2IDF Diabetes Atlas 2019.
3Collaboration on emerging risk factors, Sarwar N., Gao P. et al. Diabetes mellitus, fasting blood glucose levels, and risk for vascular disease: a collaborative meta-analysis of 102 prospective studies. lancet. 2010; 375: 2215- 2222.
4thKhera AV, Chaffin M, Aragam KG et al. Genome-wide polygenic scores for common diseases identify individuals at risk commensurate with monogenic mutations. Nat Genet. 2018; 50: 1219- 1224.
Funding: National Institute for Health Research? Cambridge University Biomedical Research Center.
Details: Research grants: Merck, Novartis, Amgen, Esperion Therapeutics, Ionis Pharmaceuticals. Consultancy fees, advisory boards, fees: Merck, Amgen, Regeneron, Sanofi, Novartis, Pfizer, Eli Lilly, Novo Nordisk, The Medicines Co., Mylan, Daiichi Sankyo, Silence Therapeutics, Ionis Pharmaceuticals, DalCOR, CiViPharma, KrKaPhamaceuticals, Medtronic, American College of Cardiology, European Society for Atherosclerosis, European Society for Cardiology.
