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8 Jan, 13 | by Dr Dean Jenkins

Welcome to the BMJ Group Diabetes Blog which has now launched!

This Blog will be maintained by a team of writers mostly made up of the faculty of the Postgraduate Diploma in Diabetes programme run by BMJ Learning and validated by the University of Leicester.

We hope to bring comments and opinions about diabetes, the different perspectives, latest scientific discoveries, reports of conferences, and the views of people with diabetes.

Looking forward to a much wider discussion and hoping to share some of the enthusiasm and advocacy for diabetes that we see on the Diploma programme.

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  • Samit Ghosal

    Hi, Wonderful to be a part of this community. Looking forwards to interacting with all through this blog.

  • Christos Kazazis

    Hi everyone it is an honor to be part of this effort. I am also looking forward to our discussions

  • Christos Kazazis

    Hi everyone I am looking forward to our discussions.

  • Great! I am really proud to be part of this community! Looking forward to interesting discussions !

  • Samit Ghosal

    Wonderful to be a part of this prestigious blog. Looking forwards to some livel;y interactions.

  • The Framingham study has been highly influential to demonstrate that obesity was associated with CV disease. In contrast, studies outside the USA were unable to link obesity to CV risk. Autopsy studies examining the relationship between coronary plaques and obesity also have conflicting results; an association was found for men (and not women) in the USA and very little relationship was found outside of the USA. When the Framingham population’s risk for CV disease was explored with multivariate analysis, BP, lipids and diabetes proved to be much more powerful predictors of CV disease than obesity. Obesity in the absence of diabetes or hypertension results in only a modest increase risk in mortality. Clearly, obesity itself as measured by BMI is only weakly related to the risk of death. Furthermore, It is well established that different body shapes influence the risk for diabetes and mortality. Obesity-related mortality is higher in men than women and men tend to have central obesity with women having more peripherally distributed fat deposits. Regional fat distribution is more important than BMI itself in determining abnormal glucose dynamics. Carefully performed clamp studies of insulin resistance found that truncal and not intraperitoneal fat was the closest correlate to insulin resistance in diabetic patients. The risk for development of diabetes is low for high-BMI patients with large accumulations of lower body fat and high for those with preferentially central fat stores. We have also learnt some lession from bariatric surgery now. Longevity studies of bariatric surgery when performed using BMI criteria have either shown very small or no longevity benefits from the operations. One major trial showed that reduced mortality attributable to bariatric surgery was not associated with weight loss. Given the lack of a clear relationship between BMI and mortality and the minimal impact, if any, of bariatric surgery on mortality, BMI is probably not an appropriate basis on which patients should be selected for surgery. Its high time we should think about WHtR (Waist/Ht ratio)…

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