Obesity not a red flag for spotting diabetes

NEW YORK (Reuters Health) - Obese people with diabetes are just as likely to go undiagnosed as their slimmer peers with the disease, Harvard Medical School researchers report.

It's well recognized that obesity increases the likelihood of developing diabetes, yet "obesity does not increase the likelihood that an individual's diabetes will be diagnosed," Dr. Christina C. Wee and her colleagues from Harvard and Beth Israel Deaconess Medical Center in Boston report.

There is no consensus on who should be screened for diabetes, Wee and her team note in their report in the medical journal Diabetes Care. Early diagnosis of diabetes is particularly important for obese people, they add, because research shows they are less likely to be offered the preventive care that can help stave off serious complications of the disease.

To investigate the impact of a person's body mass index (BMI) on their odds of having undiagnosed diabetes, the researchers looked at 5,514 people participating in the 1999-2004 National Health and Nutrition Examination Survey.

Almost 10 percent of the study participants had diabetes, and 28 percent of them had not been diagnosed with the disease. A person's BMI made no difference from a statistical standpoint in whether or not they went undiagnosed; 22 percent of normal weight people with diabetes were undiagnosed, 32 percent of overweight people were, and about 33 percent of obese people were.

Further research is needed to understand whether including overweight and obesity in diabetes screening initiatives may be beneficial for public health, Wee and her colleagues add. Meanwhile, they add, "Clinicians and policy makers may want to consider the underlying risk of diabetes associated with body weight in making decisions concerning whom should be screened for diabetes."

SOURCE: Diabetes Care, September 2008.