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Aims/Introduction  To investigate the relationship between different body mass index ( BMI ) levels and vascular complications in type 2 diabetes mellitus patients.    Materials and Methods  Data were collected from 3,224 individuals with type 2 diabetes mellitus (male/female: 1,635/1,589; age 61.31 ± 11.45 years), using a retrospective case study design. The association of  BMI  quintiles and  diabetes mellitus  vascular complications was assessed using multiple logistic regression models adjusting for age, sex, diabetes duration, smoking status, drinking and other confounders, using those with the lowest quintile of  BMI  as the reference group.    Results  With increasing  BMI , the detection rate of diabetic peripheral neuropathy and peripheral arterial disease initially decreased and then it increased, whereas the detection rate of diabetic kidney disease and carotid atherosclerotic plaques showed an upward trend; however, diabetic retinopathy was irregular. The odds ratios of  diabetic peripheral neuropathy  decreased as  BMI  increased from the 21st percentile to the 80th percentile initially, and increased when  BMI was in  >80th percentile. The same result was shown in  peripheral arterial disease .  BMI  >80th percentile showed a 1.426‐fold risk of  diabetic kidney disease  and a 1.336 ‐fold risk of carotid atherosclerotic plaque.    Conclusions  In patients with type 2 diabetes mellitus, the relationship between different  BMI s and vascular complications varies. A U‐shaped relationship was observed between  BMI  and  diabetic peripheral neuropathy,  as well as  BMI  and  peripheral arterial disease .  BMI  is positively correlated with  diabetic kidney disease  and carotid atherosclerotic plaque; however, it is not correlated with  diabetic retinopathy .

Lower body mass index is not of more benefit for diabetic complications