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The Obesity Paradox in Diabetes

  • Diabetes and Cardiovascular Disease (S Malik, Section Editor)
  • Published:
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Abstract

Overweight or obese adults have demonstrated a survival advantage compared with leaner adults in several population-based samples. This counterintuitive association has been termed the obesity paradox. Evidence for an obesity paradox among persons with diabetes has been less consistent. In the present review, we identified 18 longitudinal studies conducted in cohort studies, patient registries and clinical trial populations that tested the associations between obesity and survival in patients with diabetes. The majority of these studies reported that mortality was lowest in overweight and obese persons, and that leaner adults had the highest relative total and cardiovascular mortality. Some of these studies observed the patterns most strongly in older (age > 65 years) adults. To date, little research has been conducted to identify mechanisms that could explain elevated mortality in leaner adults with diabetes, or to identify strategies for diabetes management or mitigation of elevated mortality risk.

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Conflict of Interest

Mercedes R. Carnethon has received honoraria from the American Diabetes Association for a talk on metabolically obese normal weight and mortality.

Laura J. Rasmussen-Torvik declares that she has no conflict of interest.

Latha Palaniappan declares that she has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA

    Mercedes R. Carnethon & Laura J. Rasmussen-Torvik

  2. Palo Alto Medical Foundation Research Institute, Palo Alto, USA

    Latha Palaniappan

Authors
  1. Mercedes R. Carnethon
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  2. Laura J. Rasmussen-Torvik
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  3. Latha Palaniappan
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Correspondence to Mercedes R. Carnethon.

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This article is part of the Topical Collection on Diabetes and Cardiovascular Disease

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Carnethon, M.R., Rasmussen-Torvik, L.J. & Palaniappan, L. The Obesity Paradox in Diabetes. Curr Cardiol Rep 16, 446 (2014). https://doi.org/10.1007/s11886-013-0446-3

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  • DOI: https://doi.org/10.1007/s11886-013-0446-3

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