Dig a Bit Deeper!

In a recent Nutrition and Diabetes journal article the authors conclude:

Most studies examining the relationship of body mass index (BMI) with mortality in diabetic persons suggest a paradox: the BMI category with lowest associated mortality risk (overweight or obese) is higher than it is in non-diabetic persons (normal weight)

Let's try this in English. They seem to state that Type 2 Diabetics with lower BMI have higher mortality.

They continue:

In conclusion, in comparing physical and mental health status by BMI category in concurrent national samples of diabetic and non-diabetic persons, we found evidence of a physical (but not mental) health status paradox in diabetes. Physical health status was most optimal in the overweight category among diabetic persons, versus in the normal-weight category among non-diabetic persons. Given that physical health status influences mortality risk, the findings suggest possible pathways to a BMI mortality paradox in diabetes.

Now this article leaves several questions. They seem to mix Type 1 and Type 2 Diabetes. It is not really clear in reading.

Second, perhaps if one has Diabetes and has low BMI then one may have a totally different form of Diabetes.

Third, in examining anything like this one needs the history of each patient. Not just a single time sample. How heavy were they when the Diabetes started? Just to begin with.

The Tables state Diabetes, but what type?

Type 2 Diabetes with BMI under 20? I find that amazing. One is on the verge of ketosis and yet they have Type 2 Diabetes. It makes no sense. Unless of course it is something else.

Perhaps we should have seen a picture of the authors? Just a thought.