Increases in diabetes prevalence over recent decades disproportionately comprised of extremely obese subjects
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The study was conducted to examine the extent to which increases in the prevalence of overweight, obesity, and severe obesity have contributed to the increase in diabetes prevalence among US adults between 1976-1980 and 1999-2004. To this end, data of 37606 US adults aged 20-74 years from 3 consecutive US national surveys were used. Body mass index distributions among prevalent diabetes cases were compared over time; changes in prevalence of 5 diabetes-body mass index categories were divided by changes in diabetes prevalence observed in the total study population. Prevalence of diabetes among adults increased from 5.08% in 1976-1980 to 8.83% in 1999-2004. Of the additional 3.75 additional cases per hundred observed in 1999-2004, -8% were among subjects with normal or below normal weight, 27 % among overweight subjects (BMI 25-30 kg/m2), 32% among those with class I obesity (BMI 30-35) , 23% with class II obesity (BMI 35-40) and 26% with class III obesity (BMI>40). Therefore, of the additional diabetes cases observed in 1999-2004, 81% were obese and 49% had class II or III obesity. The authors conclude that the increases in diabetes prevalence over recent decades have been disproportionately comprised of subjects with frank to extreme levels of obesity.
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