Screening for diabetes could be improved by taking into account people’s body mass index (BMI) history, as well as their current BMI, a new study suggests.

Hirohito Sone, of Niigata University Faculty of Medicine, Japa, and colleagues found a strong association between highest lifetime BMI and the likelihood of having undiagnosed type 2 diabetes in high-risk individuals. Change in BMI between the age of 20 and the lifetime maximum was also strongly linked to undiagnosed diabetes.
“This is possibly because both weight histories are less likely to be influenced by an age-dependent decline in the association between obesity and diabetes”, Sone explained.
For the study, the researchers examined 16,226 Japanese men and 7026 women aged 30 to 75 years and without a history of diagnosed diabetes. The rate of undiagnosed type 2 diabetes was estimated to be 3.3% among the participants.
They found lifetime maximum BMI to be the strongest indicator of diabetes in both genders, independent of other factors such as age, high blood pressure, dyslipidaemia and family history of diabetes. Change in BMI between age 20 and lifetime maximum also had a substantial association with the disease, as did current BMI.
In people aged 50 or above, the strongest predictors of diabetes were lifetime maximum BMI and change between age 20 and lifetime maximum – more so than current BMI. In younger participants, however, lifetime maximum and current BMI were equally predictive.
The researchers concluded: “These results suggest that guidelines for screening for diabetes might be made more effective by introducing past high levels of BMI into the screening assessment.”

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