A Population Perspective on Diabetes Prevention
Whom should we target for preventing weight gain?
- James P. Burke, PHD1,
- Ken Williams, MS2,
- K.M. Venkat Narayan, MD3,
- Cynthia Leibson, PHD1,
- Steven M. Haffner, MD2 and
- Michael P. Stern, MD2
- 1Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
- 2Department of Medicine, Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
- 3National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
- Address correspondence and reprint requests to James P. Burke, PhD, Dept. of Health Sciences Research, Harwick 6, Mayo Clinic, 200 First St. SW, Rochester, MN 55905. E-mail: jburke{at}mayo.edu.
Abstract
OBJECTIVE—To examine the influence of obesity and prevention of weight gain on the incidence of type 2 diabetes.
RESEARCH DESIGN AND METHODS—We examined participants in the San Antonio Heart Study, a prospective population-based study of Mexican Americans and non-Hispanic whites residing in San Antonio, Texas. BMI was stratified into four categories: normal (<25 kg/m2), overweight (≥25 kg/m2 and <30 kg/m2), obese (≥30 kg/m2 and <35 kg/m2), and very obese (≥35 kg/m2). The number and proportion of incident cases prevented by targeting each BMI category were estimated. In addition, we calculated the decrease in risk of developing type 2 diabetes associated with weight gain prevention across both the BMI and age spectra.
RESULTS—Preventing normal individuals from becoming overweight would result in the greatest reduction in incidence of type 2 diabetes. This would result in a 62 and 74% reduction in the incidence of type 2 diabetes in Mexican Americans and non-Hispanic whites, respectively. Preventing the entire population from gaining, on average, 1 BMI unit would result in a reduction in incidence of type 2 diabetes of 12.4 and 13.0% in Mexican Americans and non-Hispanic whites, respectively.
CONCLUSIONS—The majority of cases of type 2 diabetes were in individuals who were overweight or mildly obese with a family history of type 2 diabetes. Public health resources should be directed toward the prevention of weight gain among normal and overweight individuals in order to prevent the maximum number of cases of type 2 diabetes.
Footnotes
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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- Accepted March 19, 2003.
- Received January 3, 2003.
- DIABETES CARE
