Article Text
PDF
Abstract
Objective This study evaluated relationships between glycaemic control, body mass index (BMI), comorbidities and pharmacological treatment in patients with type 2 diabetes mellitus (T2D).
Research design and methods This was a retrospective, cross-sectional analysis of Quintiles electronic medical records research data (study period 1 October 2013–30 September 2014). Eligibility included age ≥18 years, T2D diagnosis, and at least one available BMI measurement.
Results The study included 626 386 patients (mean age, 63.8 year; 51.3% female; 78.5% white; 62.6%, BMI ≥30 kg/m2). A1c data were available for 414 266 patients. The proportion of patients with good glycaemic control (A1c ≤6.5) decreased as BMI category increased, ranging from 40.1% of patients with BMI <30% to 30.1% of patients with BMI ≥40. The proportions of patients with poor glycaemic control (A1c >8% and A1c ≥9%) increased with increasing BMI category. Oral antidiabetic drugs (OAD) were the most frequently used (54.4% of patients with A1c values). Among patients using insulin-based therapy, 50% had an A1c ≥8% and 29% had an A1c ≥9% regardless of concomitant OAD or glucagon-like peptide 1 receptor agonist use. Among patients using three or more OADs, 34.3% and 16.1% had A1c values ≥8% and ≥9%, respectively. There was no common trend observed for changes in the proportion of patients with T2D-related comorbidities according to BMI category. The most notable trend was a 7.6% net increase in the percentage of patients with hypertension from BMI <30 to BMI ≥40.
Conclusions This large dataset provides evidence that roughly one out of four patients with T2D is not well controlled, and the prevalence of poor glycaemic control increases as BMI increases.
- Type 2 diabetes
- obesity
- glycaemic control
- Comorbidity
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Statistics from Altmetric.com
Footnotes
Contributors WW, YT, TMH, SXK, BS, and JB were involved in study concept and design. YT conducted data collection. WW, YT, and ESK were involved in data analysis and interpretation. WW and EK contributed to the outline and first draft of the manuscript. WW, YT, ESK, TMH, SXK, BS, and JB all critically revised the manuscript at each stage and provided final approval of the manuscript.
Funding This study was funded by Novo Nordisk (Plainsboro, New Jersey). The authors received writing and editorial assistance from Judith Adams, PharmD and Sandra Westra, PharmD (Churchill Communications, Maplewood, New Jersey, USA) with funding from Novo Nordisk.
Competing interests WW and TMH are employees and stockholders of Novo Nordisk. SXK is an employee of Novo Nordisk. JB, EK, BS and YT were employees of Novo Nordisk at the time the study was performed.
Provenance and peer review Not commissioned; externally peer reviewed.