Study Dispels “Obesity Paradox” in Diabetes

A study in the New England Journal of Medicine finds no evidence of a so-called “obesity paradox” in type 2 diabetes — that is, the suggestion that mortality is lower among diabetics who are overweight or obese than among those who are normal weight.

Researchers studied over 11,000 healthcare professionals who were free of cardiovascular disease or cancer at the time of diabetes diagnosis. During 16 years’ follow-up, roughly 3000 participants died.

Overall, the association between baseline BMI and all-cause mortality was J-shaped: Compared with normal-weight participants, underweight participants and those with BMIs of 30 or above had significantly increased mortality risks, with the highest risk at BMIs of 35 or higher (hazard ratio, 1.33).

Previous studies that suggested an obesity paradox were limited by short follow-ups and few deaths, the authors write. They conclude that maintaining a healthy weight “should remain the cornerstone of diabetes management.”

– See more at: http://www.nejm.org/doi/full/10.1056/NEJMoa1304501

Comprehensive Management of Diabetes – 2013 AACE Guidelines

Diabetes. It’s something we all have to manage at some point. Whether you are working in a primary care clinic or working as a hospitalist, there is a very good chance that at least some of your patients will have diabetes. So, in order to deliver the best care in an evidence-based way, guidelines have been developed and are routinely updated.

Below are the 2013 guidelines on the comprehensive management of diabetes from the American Association of Clinical Endocrinologists. Continue reading

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