Glycemic control of Obese Patients with Type 2 Diabetes Mellitus

Abstract

Background and Objective: The incidence of type 2 diabetes mellitus is growing. Some national studies have measured glycemic control in people with type 2 diabetes mellitus. The objective of this study was to measure the glycemic control in obese patients with type 2 diabetes mellitus. Methods: A retrospective study of patients with type 2 diabetes mellitus and body mass index >30.0 kg/m2 at the primary health care department and diabetic Centre. Results: A total of 809 participants with T2DM and BMI ≥30.0 kg/m2 were studied. The mean age of the study population was 53.1 ± 11.6 years with 54.5 ± 12.5 years for males and 52.5 ± 11.1 years for females, p=0.02. Moreover, the prevalence of males was 248(30.7%) and the prevalence of females was 561(69.3%) with males to females ratio was 1.00: 2.26, p<0.0001. Mean BMI was 35.3 ± 4.7 kg/m2 and mean HbA1c was 9.3 ± 2.3. In the study population, 458(56.6%) were obese Grade I, 242 (29.9%) were obese Grade II while 109 (13.5%) were morbidly obese (obese Grade III), p=0.001 was significant compared to non diabetic cases. Obese Grade I have significantly a higher HbA1c compared to obese Grade II and III. Higher HbA1c was significantly correlated with lower BMI, r= - 0.1, p=0.002. Moreover, increased BMI were strongly linked to females; 60.7%, 77.7% and 87.2% respectively and were found to be statistically significant (P < 0.0001), as indicated in table. Summarizes the relationship between mean HbA1c according to obesity categories stratified by gender figure 1. There is a clear no significant separation of the HbA1c line between the males and females where mean HbA1c for males were higher in all obesity categories. There were slopes up of the mean Hba1c with slope down line for mean BMI as age groups advanced with similar pattern for males and females. A better HbA1c goal in BMI (30-34) group and that was true for females. The frequency of Hba1c goal was increasing with increasing age groups. Conclusion: These data indicate that many obese patients with T2DM have poor glycemic control where they will be at high risk of diabetic complications. More national studies are needed to assess glycemic control among obese diabetic patients in Saudi Arabia.