A brainchild of Dr R M Anjana, and her team, the study – Chennai Urban Rural Epidemiology Study (CURES), reports on the mortality rates based on a representative sample of 26,001 adults from Chennai , aged over 20 years out between 2001 and 2003.
While the study revealed the startling outcome that the mortality rates are almost three times higher in Indians with diabetes compared to Indians without diabetes, it also further stated that being underweight was associated with a significantly higher risk of all-cause mortality compared to those who were marginally overweight or obese.
This supports the newly emerging ‘obesity paradox’ concept and suggests that being slightly overweight especially at older age groups may not be such a bad thing after all.
Dr. R. M. Anjana, Managing Director, Dr. Mohan’s Diabetes Specialities Centre and Vice president, MDRF says, “To our knowledge, this is the first study from India to compare mortality rates in a representative population based cohort of individuals with and without diabetes. Coronary heart disease which contributed 53% of the risk of mortality in those with diabetes can be reduced if it is diagnosed and detected early and aggressively. Diabetes which is a significant contributor to mortality can also be prevented. Even if it is well controlled, it could also reduce the mortality rates”.
She further adds, “Other important contributors to mortality such as physical inactivity, dyslipidemia, smoking and alcohol use and hypertension are also easily modifiable risk factors”.
While there are several studies on mortality rates in people with and without diabetes from developed countries; there is virtually no data from India. Such data are very important because Indians, in general, are known to be at increased risk of developing both type 2 diabetes as well as premature coronary heart disease.
Dr V. Mohan, Director, Madras Diabetes Research Foundation says that “The excess mortality noted among underweight individuals may reflect their poor health due to other underlying diseases e.g. tuberculosis, under nutrition or decreased immunity. The fact that excess mortality due to diabetes was highest in the age group of 51 to 70 years is possibly a reflection of the earlier age of onset of type 2 diabetes in Indians. While, gross obesity is undoubtedly harmful, this study shows that small degrees of overweight especially in older people may not be as bad as believed earlier.”