Is the Recent Rise in Type 2 Diabetes Incidence From 1984 to 2007 Explained by the Trend in Increasing BMI?

OBJECTIVE: To estimate the extent to which increasing BMI may explain the rise in type 2 diabetes incidence in British men from 1984 to 2007. RESEARCH DESIGN AND METHODS: A representative cohort ratio of 6,460 British men was followed-up for type 2 diabetes incidence between 1984 (aged 45-65 years) and 2007 (aged 67-89 years). BMI was ascertained at regular intervals before and during the follow-up. RESULTS: Between 1984-1992 and 1999-2007, the age-adjusted hazard of type 2 diabetes more than doubled (hazard ratio 2.33 95% CI 1.75-3.10). Mean BMI rose by 1.42 kg/m(2) (95% CI 1.10-1.74) between 1984 and 1999; this could explain 26% (95% CI 17-38) of the type 2 diabetes increase. CONCLUSIONS: An appreciable portion of the rise in type 2 diabetes can be attributed to BMI changes. A substantial portion remains unexplained, possibly associated with other determinants such as physical activity. This merits further research.