Every person has a target weight they must stay below or they risk getting type 2 diabetes, a study suggests.
Researchers looking at half a million Britons said people appear to have a personal body mass index (BMI) threshold which triggers abnormal blood sugar levels.
They claim millions of people could avoid developing diabetes if they kept their weight in a healthy range below that target.
And for those who are diagnosed with type 2 diabetes, the condition can be reversed entirely by aggressively reducing calories, the scientists say.
Because BMI is specific to each individual, everybody will have a different threshold at which they are deemed ‘overweight’ or ‘obese’ and risk developing diabetes.
For example, a 6ft (182cm) man would be considered healthy if they weighed 13 stone (82kg) whereas a 5ft 4inch (164cm) woman would be deemed obese.
BMI is a crude measure that uses height and weight to work out if someone is a healthy weight.
The researchers haven’t given exact figures, but they say their findings will help doctors identify who is most at-risk of diabetes, based on their weight.
Every person has a BMI target they must stay below or they risk getting type 2 diabetes, researchers say. Being overweight or obese drives up the risk by up to ten times
The study, conducted by the University of Cambridge, looked at 445,765 people in the UK Biobank.
Scientists wanted to find out what put patients at a higher risk of type 2 diabetes – genetics or a high BMI.
They found those deemed severely obese, who had a BMI of 35 or more, had an 11-fold increased risk of diabetes compared to the lowest group, with an average BMI of 21.7.
That was the case even when genetic predispositions to the condition – such as a family history of diabetes – were factored in.
HOW TO CALCULATE YOUR BODY MASS INDEX – AND WHAT IT MEANS
Body mass index (BMI) is a measure of body fat based on your weight in relation to your height.
For children and young people aged 2 to 18, the BMI calculation takes into account age and gender as well as height and weight.
Ethnicity can also affect the risk of some health conditions. For example, adults of Asian origin may have a higher risk of health problems at BMI levels below 25.
Standard Formula:
BMI = (weight in pounds / (height in inches x height in inches)) x 703
Metric Formula:
BMI = (weight in kilograms / (height in meters x height in meters))
Measurements:
Under 18.5: Underweight
18.5 – 24.9: Healthy
25 – 29.9: Overweight
30 or greater: Obese
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Unveiling the findings at the annual European Society of Cardiology (ESC) Congress today, lead researcher Professor Brian Ference said the study was quite clear.
‘The findings indicate that BMI is a much more powerful risk factor for diabetes that genetic predisposition,’ he said.
‘This suggests that when people cross a certain BMI threshold, their chances of diabetes go up and stay at that same high-risk level regardless of how long they are overweight.’
Most cases of the disease could either be prevented or reversed if someone’s BMI was kept below their personal cut-off point at which abnormal blood sugar levels are triggered, Professor Ference said.
Everyone will have a different threshold which sees them at risk of becoming diabetic, explaining why some people with a healthy weight develop the condition and some who are overweight do not, he added.
Explaining further the significance of the study, he said: ‘You can prevent most cases of diabetes by keeping BMI below a person’s threshold.
‘But it (the study) also implies something that we haven’t focused on in the past and that is we can also probably reverse most cases of diabetes if we lower somebody’s BMI aggressively below their BMI threshold relatively soon after they develop diabetes.
‘I think the fact that BMI appears to have a threshold rather than a cumulative effect on the risk of diabetes really has potentially significant implications for how we think about changing screening, preventing, treating and reversing diabetes.’
Professor Brian Ference said the findings of the study could have ‘significant implications’ for the approach to screening for, preventing, treating and even reversing the condition.
He said by the end of this year or early next year, the team might make a breakthrough in working out how to estimate what each individuals diabetes BMI threshold is.
The British Heart Foundation (BHF) said the findings highlight the need to regularly measure BMI and track blood sugar levels of people at high risk.
CAN DIABETES BE REVERSED?
It is possible to put type 2 diabetes into ‘remission’, when blood sugar levels are below the diabetes range and the patient no longer needs to take medication.
The term ‘reversed’ is not often used because it implies cured. But there is no guarantee a person who has had type 2 diabetes is free from the disease forever.
The strongest evidence for reaching type 2 diabetes remission points towards weight loss in people who are carrying extra weight or have obesity.
Scientists believe that storing too much fat in the liver and pancreas affects how type 2 diabetes develops and losing this fat can help put the disease into remission, according to Diabetes.org.
The website says: ‘In fact, losing around 15kg significantly increases your chances of type 2 diabetes remission.’
It’s easier to get diabetes into remission closer to the time of diagnosis.
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Professor Jeremy Pearson, the organisation’s associate medical director, said: ‘This important study of nearly half a million people shows that BMI is a more vital risk factor for type 2 diabetes than we previously realised.
‘When someone’s BMI goes above their personal threshold, blood sugar levels increase, triggering the onset of type 2 diabetes, which can lead to damaged blood vessels and increased risk of developing heart and circulatory diseases.
‘If you are overweight, making small, long-term changes to your lifestyle such as reducing portion sizes and being more physically active can help lower your BMI, which is good for your heart and blood vessels.’
The study also showed it didn’t matter how long someone had been overweight for but what was important was whether they had crossed their own threshold of healthy risk-free weight.
It is known the most successful way of putting type 2 diabetes into a remission state is to lose weight, with the Mediterranean diet or a low-carb diet being encouraged by doctors.
In 2019, approximately 463million people worldwide had diabetes, including 4.7million in the UK and 34.2million in the US.
The vast majority of cases (around 90 per cent) are type 2 diabetes, which is often triggered by being overweight, not exercising, and eating an unhealthy diet.
Genetic make-up may also identify individuals with a greater likelihood of developing the condition, but this appears to be less important than lifestyle.
More people than ever are at risk of type 2 diabetes, according to charities, and cases are expected to reach five million in the UK in five years time in line with rising obesity prevalence.
Inherited risk of diabetes was assessed in the study using 6.9million genes.
Participants’ height and weight were measured at enrolment to calculate their BMI.
By a standard rule of thumb, people with a BMI of 25 to 29.9 are overweight, and those with a BMI over 30 are obese.
But there is no specific BMI number at which type 2 diabetes is likely to occur, although it is known to be lower in black, Asian and other minority ethnic groups.
Participants, just over half of whom were women, had an average age of 57 and were followed up until an average age of 65.
During that period 31,298 (seven per cent) of them developed type 2 diabetes.
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