Does a rise in BMI cause an increased risk of diabetes?: Evidence from India

Abstract

BackgroundOvernutrition increases the risk of diabetes. Evidence on the causal impact of overnutrition on diabetes is scarce for India. Considering a representative sample from India, this study examines the causal effect of a rise in the Body Mass Index (BMI) of an individual on the likelihood of being diabetic while addressing the issue of unobserved endogeneity between overnutrition and diabetes. MethodsThe study considers individual level data from Demographic and Health Surveys (DHS) of India, namely, National Family Health Survey (NFHS) for the year 2015-16. The NFHS is a large-scale, multi-round survey conducted in a representative sample of households throughout India. The survey covers females having age 15-49 years and males having age 15-54 years. The instrument variable approach is used to address the potential endogeneity in the relationship between BMI and diabetes. We instrument BMI of an individual by BMI of a non-biologically related household member. Ordered Probit, Probit and IV-Probit models are estimated using two alternative definitions for measuring diabetes-self-reported diabetes status and blood glucose levels (ordinal measure). ResultsThe coefficients obtained from the Ordered Probit and Probit models are much smaller than those estimated by an IV-Probit model. The latter estimates the causal impact of a rise in BMI on diabetes by taking into account the effect of the unobserved genetic and other related factors. The likelihood of being diabetic is twice or more among the overweight and obese individuals as compared to non-overweight individuals in all the specifications. With a unit increase in BMI the probability of being diabetic increases by about 1.5% among overweight and obese individuals and by 0.5% among the non-overweight individuals in the IV-Probit model. Similar results from the Ordered Probit model show that on average, the overweight and obese individuals experience about 0.2% increase in the probability of being diabetic and about 0.4% increase in the probability of being prediabetic. PLOS ONEPLOS ONE | https://doi.org/10.1371/journal.pone. ConclusionOur study demonstrates that the likelihood of being both prediabetic and diabetic is higher among the overweight and obese individuals as compared to the non-overweight individuals. We also find that the level of risk of being prediabetic or diabetic differs across gender, wealth quintiles and regions and the effects are more severe among population in the urban areas, belonging to the richest wealth quintile and men. Our findings have significant implications for the policy formulation as diabetes has a substantial health and economic burden associated with it. Future studies may investigate the effect of abdominal obesity on diabetes. PLOS ONEDoes a rise in BMI cause an increased risk of diabetes? PLOS ONE | https://doi.

Drug Prescribing Pattern and Cost-Effectiveness Analysis of Oral Antidiabetic Drugs in Patients With Type-2 Diabetes Mellitus: Real-World Data From Indian Population.

“…The strong association between BMI and diabetes indicated that even minor BMI changes had adverse effects on the population. A similar study has been reported in the Indian population [9]. A total of 30% of patients had a family history of diabetes.…”

Prevalence of Prediabetes and Undiagnosed Diabetes Among Kuwaiti Adults: A Cross-Sectional Study

“…Such observations are consistent with prior reports that showed elevated prevalence estimates of prediabetes and undiagnosed T2DM among obese and older individuals. 9,12,14,23,[28][29][30] As for sex differences, our study results showed that HbA1c-defined prediabetes and undiagnosed T2DM prevalence estimates were higher among males compared to females. These results are concomitant with results from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 study, which showed that men are more likely than women to have prediabetes and undiagnosed T2DM.…”

Interleukin-37 is down-regulated in serum of patients with severe coronavirus disease 2019 (COVID-19)

“…It was also observed that 80% of COVID-19 patients were overweight/obese. Overweight and obesity are major known risk factors for the development of diabetes and cardiovascular disease [25] . It has become evident that these conditions (diabetes, cardiovascular disease and obesity) make individuals more susceptible to develop severe COVID-19 with increased morbidity and mortality [26] .…”