A new study shows that persistent underweight condition in diabetic patients is associated with a higher risk of developing heart failure in the future.

Kangbuk Samsung Hospital said Tuesday that a joint research team has found it after following up on the body mass index (BMI) and risk of heart failure of 1,268,383 patients with type 2 diabetes who underwent the National Health Insurance Service's national health checkup from 2009 to 2012.

Professors Lee Won-young and Rhee Eun-jung of the hospital's Department of Endocrinology, Professor Yoo Tae-kyung of the MetroWest Medical Center, and Professor Han Kyung-do Soongsil University conducted the study.

The prevalence of heart failure in people with diabetes is reported to be as high as 22 percent, four times the prevalence of heart failure in the general population. Heart failure is also associated with a poorer prognosis in people who are underweight than in those who are normal weight. However, there have been few previous researches on the impact of being underweight on new-onset heart failure in people with diabetes.

The researchers analyzed the effect of new-onset heart failure in diabetes patients based on BMI four years prior to the start of the study and BMI at the start of the study, dividing the patients into three groups: a persistent normal weight group with all BMIs in the normal range (≥18.5 kg/m2); a persistent underweight group with all BMIs in the underweight range (<18.5 kg/m2); a group that changed from normal weight to underweight; and a group that changed from underweight to normal weight.

The results showed that the risk of heart failure increased by 39 percent among those who shifted from normal to low weight and those who shiftined from low to normal weight compared to the persistently normal weight group.

However, the persistently underweight group showed the highest risk of heart failure, with a 61 percent increase.

"This study suggests that the longer a person is underweight in type 2 diabetes, the higher the risk of heart failure gets," Professor Lee Won-young, lead author of the study, said. "We assume this may be due to nutritional deficiencies or metabolic disorders that lead to muscle wasting and fat loss, which in turn trigger an inflammatory response in the body."

He emphasized that it is important to be aware of the increased risk of heart failure in people with diabetes and to actively manage it.

"In addition to lifestyle management, including healthy eating and exercise, patients with diabetes should seek medical attention to prevent heart failure and cardiovascular disease,” Professor Lee said.