Over 20 million American adults have diabetes and that number is rising at an alarming rate—1.5 million people were diagnosed in 2005 alone. Among the complications of diabetes are heart disease , stroke , blindness, kidney disease, nerve damage, and amputations. Diabetes may also increase the risk of early death. Obesity , defined as a body mass index (BMI, or weight in kilograms divided by height in meters squared) of 30 or greater, is a major risk factor for diabetes. Studies of critical illnesses and subsequent death have suggested links with diabetes and obesity, but the exact connections are unclear.

Researchers evaluated the influence of obesity and diabetes on the risk of acute organ failure (a sign of critical illness) and death within three years. Their study, published on September 25, 2006 in Critical Care , reports that people with diabetes had three times the risk of organ failure and subsequent death within three years compared with non-diabetics. Obesity alone had no effect on these risks.

About the Study

Researchers at the University of Kentucky Medical Center analyzed data on 15,408 participants in a community-based study of heart disease, which ran from 1986-1989 and included adults aged 44-66. At baseline, researchers measured BMI and collected information on health, including the presence of diabetes. They then monitored the volunteers’ hospital records for the next three years looking for cases of organ failure and death. The risks of organ failure and death were compared between people with and without diabetes and across BMI categories (normal weight, overweight, and obese).

People with diabetes had triple the risk of organ failure and subsequent death within three years than people without diabetes. While obesity was more common among those with diabetes, obesity itself did not affect the study outcomes. After adjusting for the influence of diabetes, obese people without diabetes had the same risks for organ failure and death as people who were normal weight or overweight.

Researchers relied on hospital charts from more than 15 years ago rather than in-person evaluations to collect their data, which could limit the accuracy of these findings. Also, three years of follow-up is fairly short; over a longer term, people with high BMIs are very likely to develop diabetes and its related complications, including organ failure and death.

How Does This Affect You?

According to this study, diabetes—and not obesity—dramatically raises the risk for acute organ failure and subsequent death. These findings highlight the dangers of diabetes, but the lack of a connection between obesity and the study outcomes by no means exonerates excess weight as a significant health risk. This study in no way discounts the many other complications of obesity, including high blood pressure, heart disease, stroke, osteoarthritis, sleep apnea, some cancers, and, of course, diabetes itself.

To achieve and maintain an ideal weight, consider these lifestyle changes, which also minimize your risk for other chronic diseases:

  • Exercise regularly
  • Eat reasonable portion sizes (e.g., by using smaller plates and bowls)
  • Choose high-fiber fruits, vegetables, and whole grains
  • Limit saturated and trans fats as well as sugary foods (soda, candy, etc.)
  • Recognize and change emotional eating
  • Find non-food means of stress relief, such as exercise

If you have diabetes, be vigilant with your diet, exercise, and if needed, medications, to keep your blood sugar under control. To reduce your risk of developing diabetes, lose excess weight and strive for 30 minutes of moderate physical activity daily.