Treatment patterns and clinical characteristics of patients with type 2 diabetes mellitus according to body mass index: findings from an electronic medical records database. Issue 1 (27th May 2017)

• Record Type: Journal Article
• Authors: Weng, Wayne; Tian, Ye; Kimball, Edward S.; Kong, Sheldon X.; Bouchard, Jonathan; Hobbs, Todd M.; Sakurada, Brian
• Is Part Of: BMJ open diabetes research and care. Volume 5:Issue 1(2017)
• Publication Date: 2017-05-27
• Subjects: Type 2 diabetes -- obesity -- glycaemic control -- Comorbidity; Diabetes -- Periodicals; 616.462005
• DOI: 10.1136/bmjdrc-2016-000382
• Languages: English
• ISSNs: 2052-4897

Abstract

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/m 2 ). 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.