Diabetes, not obesity, increases risk of developing critical illness and early death

Diabetes puts people at risk of developing critical illness and dying early, but obesity without diabetes does not. A study published today in the open access journal Critical Care reveals that individuals suffering from diabetes are three times more at risk of developing critical illness and dying young than individuals who do not have diabetes. Obese individuals who do not have diabetes, by contrast, have the same risk of dying or of falling critically ill as non-obese patients who do not have diabetes. These results are surprising, as obesity is linked to diabetes. The authors of the study conclude that the relationship between obesity, diabetes and critical illness is complex and that obesity, per se, does not predict poor outcomes.

Katarina Slynkova and colleagues from the University of Kentucky Chandler Hospital collaborated with colleagues from Emory University School of Medicine to analyse data from 15,408 subjects aged 44 to 66, coming from four different US communities, who had originally been studied between 1986 and 1989. The authors analysed the subjects' body mass index (BMI), presence of diabetes (either type 1 or type 2) and the subjects' history of critical illness (acute organ failure) and mortality within 3 years.

Slynkova et al.'s results show that, in the absence of diabetes, obese individuals do not have an increased risk of suffering from acute organ failure, and of dying from acute organ failure, than non-obese individuals. By contrast, patients with diabetes are three times more likely to become critically ill with acute organ failure and they are three times more likely to die from acute organ failure, or from any cause, than patients who do not have diabetes, regardless of their BMI. Slynkova et al. conclude that diabetes is a strong independent predictor of acute organ failure and subsequent death, or death from any cause.

Article:

The Role of Body Mass Index and Diabetes in the Development of Organ Failure and Subsequent Mortality in an Observational Cohort
Katarina Slynkova, David M Mannino, Greg S Martin, Richard S Morehead and Dennis E Doherty Critical Care 2006, in press

After publication, article available from the journal website at: http://ccforum.com/. The article is available free of charge, according to BioMed Central's open access policy.