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November 28, 2012

Weight and Mortality in Adults With Diabetes

Author Affiliations

Author Affiliation: Department of Internal Medicine, Geneva University Hospitals, Geneva, Switzerland (francois.jornayvaz@hcuge.ch).

JAMA. 2012;308(20):2080-2081. doi:10.1001/jama.2012.14561

To the Editor: Dr Carnethon and colleagues1 provided evidence that adults who have normal weight at the time of incident type 2 diabetes have higher mortality than those who are overweight or obese, confirming the obesity paradox (ie, that persons can be metabolically obese but normal weight or metabolically healthy but obese).

Despite adjustment for multiple parameters such as demographic characteristics, blood pressure, lipid levels, waist circumference, and smoking status, the authors did not have access to the type of diabetes control medication and therefore could not adjust the results for this variable. However, this is important because there is increasing evidence that diabetes drugs may have their own effects on mortality.