Modest elevations in body mass index (BMI) are strongly associated with an increased likelihood of developing type 2 diabetes mellitus (T2DM) among urban Asian Indians, according to a secondary analysis published in Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

The analysis used data from the Indian Heart Watch (IHW) study, a nationwide cross-sectional survey assessing cardiovascular disease risk factors across urban populations in medium-sized Indian cities. The relationship between BMI and T2DM risk was evaluated beginning at a baseline BMI of 18.5 kg/m².

The Mantel–Haenszel test demonstrated a linear and statistically significant association. Each one-unit increase in BMI above 18.5 kg/m² corresponded to a 28% higher odds of developing T2DM (Odds Ratio 1.28; 95% Confidence Interval 1.19–1.37; p < 0.0001). Notably, the association emerged below the currently accepted overweight threshold of 23 kg/m², indicating that glycemic risk may begin at lower adiposity levels in this population.

These findings support the need to reassess BMI thresholds for diabetes risk stratification in South Asian populations. Longitudinal studies are warranted to validate this lower BMI cutoff and its correlation with glycated hemoglobin (HbA1c), enabling earlier identification and preventive interventions for T2DM.