Effect of BMI on Lifetime Risk for Diabetes in the U.S.

  1. K.M.V. Narayan, MD,
  2. James P. Boyle, PHD,
  3. Theodore J. Thompson, MS,
  4. Edward W. Gregg, PHD and
  5. David F. Williamson, PHD
  1. From the Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
  1. Address correspondence and reprint requests to K.M. Venkat Narayan, Hubert Professor of Global Health & Epidemiology, Emory University, Atlanta, GA 30322. E-mail: kmvnarayan{at}sph.emory.edu


OBJECTIVE—At birth, the lifetime risk of developing diabetes is one in three, but lifetime risks across BMI categories are unknown. We estimated BMI-specific lifetime diabetes risk in the U.S. for age-, sex-, and ethnicity-specific subgroups.

RESEARCH DESIGN AND METHODS—National Health Interview Survey data (n = 780,694, 1997–2004) were used to estimate age-, race-, sex-, and BMI-specific prevalence and incidence of diabetes in 2004. U.S. Census Bureau age-, race-, and sex-specific population and mortality rate estimates for 2004 were combined with two previous studies of mortality to estimate diabetes- and BMI-specific mortality rates. These estimates were used in a Markov model to project lifetime risk of diagnosed diabetes by baseline age, race, sex, and BMI.

RESULTS—Lifetime diabetes risk at 18 years of age increased from 7.6 to 70.3% between underweight and very obese men and from 12.2 to 74.4% for women. The lifetime risk difference was lower at older ages. At 65 years of age, compared with normal-weight male subjects, lifetime risk differences (percent) increased from 3.7 to 23.9 percentage points between overweight and very obese men and from 8.7 to 26.7 percentage points for women. The impact of BMI on diabetes duration also decreased with age.

CONCLUSIONS—Overweight and especially obesity, particularly at younger ages, substantially increases lifetime risk of diagnosed diabetes, while their impact on diabetes risk, life expectancy, and diabetes duration diminishes with age.


  • Published ahead of print at http://care.diabetesjournals.org on 19 March 2007. DOI: 10.2337/dc06-2544.

    Additional information for this article can be found in an online appendix at http://dx.doi.org/10.2337/dc06-2544.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted March 8, 2007.
    • Received December 19, 2006.
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  1. Diabetes Care vol. 30 no. 6 1562-1566
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