New research into the link between diabetes and body mass index (BMI) has been published with the hope it will help countries develop more individual and efficient diabetes screening programmes.

The study by a Massachusetts General Hospital team found that the association between BMI and diabetes risk varies among low and middle-income countries (LMICs). Their findings could help countries to tailor guidelines according to their population’s BMI risk threshold.

Rates of diabetes in LMICs have increased significantly due to rising rates of obesity, with 79% of the 463 million people with diabetes worldwide living in these countries.

More data was needed to provide healthcare professionals across the world with guidelines on who they should screen for diabetes when using BMI as a risk factor.

Dr Jennifer Manne-Goehler, from the Medical Practice Evaluation Center at Massachusetts General Hospital, said: “There are guidelines from the World Health Organization that recommend screening individuals age 40 and older with a BMI of 25 kg/m2 and above for diabetes.

“But it’s long been suspected that these BMI and age thresholds may not be optimal for diabetes screening in all regions of the world. Our goal was to estimate the relationship between BMI and diabetes risk across many low- and middle-income countries to help resource-strapped health systems devise the most effective screening programs for their populations.”

The five-year study involved a team of researchers from 57 countries, who compiled and examined data from more than 680,000 people in LMICs. It included each individual’s weight, height and a diabetes biomarker.

The team found that those with a BMI of 23 kg/m2 or more had an increased risk of diabetes. However, the optimal BMI to choose for diabetes screening varied among genders and regions. It ranged from 23.8 kg/m2 among men in East/Southeast Asia, to 28.3 kg/m2 among women in Latin America, the Caribbean, the Middle East and North Africa. The findings also revealed differences in the risk of diabetes across BMI categories in a number of regions.

Dr Manne-Goehler said: “Although the data aren’t prescriptive, our hope is that policymakers in LMICs will find this evidence useful as they try to decide how they will spend limited resources to optimize diabetes screening for their particular populations.”

The study has been published in The Lancet.

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