Abstract
BackgroundThere are few data on the prevalence of obesity and its influence on achieving blood glucose, blood pressure, and blood lipid (3B) goals in Chinese type 2 diabetes outpatients.MethodsPatient demographic data, anthropometric measurements, medications, and blood glucose and lipid profiles of 24,512 type 2 diabetes patients from a large, geographically diverse study (CCMR-3B) were analyzed. Using cut-points for body mass index (BMI) and waist circumference (WC) recommended by the Working Group on Obesity in China, overweight and obesity were defined as BMIs of 24–27.9kg/m2 and ≥28.0kg/m2. Central obesity was defined as a waist circumference ≥80cm in women and ≥85cm in men. The 3B therapeutic goals were HbA1c<7.0%, BP<140/90mmHg and LDL-C<2.6mmol/L.ResultsOverall, 43.0% of type 2 diabetes patients were overweight and 16.7% were obese; 13.3% of overweight and and10.1% of obese patients achieved all the 3B target goals. Overweight or obese patients were less likely to achieve 3B goals than those with normal BMIs. More than a half the overweight or obese patients (69.6%) were centrally obese. Patients with abdominal obesity were less likely to achieve cardiometabolic targets than those without abdominal obesity. In multivariate logistic regression analysis, female, higher BMI and waist circumference, smoking, drinking, sedentary lifestyle, and longer diabetes duration were significantly correlated with failure to achieve 3B control goals.ConclusionsObesity is highly prevalent and associated with poor 3B control in Chinese type 2 diabetes patients. In clinical practice, more attention and resources should focus on weight loss for such patients.
Highlights
The global prevalence of diabetes is rapidly increasing, and in China, the estimated prevalence of type 2 diabetes in adults rose from 2.5% in 1994 to 9.7% in 2007–2008 [1, 2]
Using cut-points for body mass index (BMI) and waist circumference (WC) recommended by the Working Group on Obesity in China, overweight and obesity were defined as BMIs of 24–27.9kg/m2 and 28.0kg/m2
In multivariate logistic regression analysis, female, higher BMI and waist circumference, smoking, drinking, sedentary lifestyle, and longer diabetes duration were significantly correlated with failure to achieve 3B control goals
Summary
The global prevalence of diabetes is rapidly increasing, and in China, the estimated prevalence of type 2 diabetes in adults rose from 2.5% in 1994 to 9.7% in 2007–2008 [1, 2]. There is strong evidence from epidemiological studies showing that obese diabetes patients are at increased risk of cardiometabolic diseases including hyperglycemia, hypertension, and dyslipidemia [3,4,5,6]. Currently no studies have directly compared the rates of achieving therapeutic goals for control of hyperglycemia, hypertension, and dyslipidemia in normal weight and obese patients with diabetes who had been receiving medical care in hospital setting. A survey of 233 type 2 diabetes patients, found that control of hyperglycemia, hypertension, and dyslipidemia was poor in 65.7%, 51.9%, and 97.1% of the subjects respectively, and that 60.1% of them were either overweight or obese [8]. Study supports the combined use of general and central obesity, as measured by BMI and WC, to assess risk of cardiovascular diseases in patients with diabetes and metabolic disorders [9]. There are few data on the prevalence of obesity and its influence on achieving blood glucose, blood pressure, and blood lipid (3B) goals in Chinese type 2 diabetes outpatients
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