Obesity and low target attainment rates in Chinese with type 2 diabetes

Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China.
European Journal of Internal Medicine (Impact Factor: 2.89). 06/2012; 23(4):e101-5. DOI: 10.1016/j.ejim.2012.02.015
Source: PubMed


Although it is known that the prevalence of type 2 diabetes and obesity is increasing in China, there is little research into how obese or non-obese patients may differ in their attainment of treatment goals for type 2 diabetes. To do this, we assessed the attainment of American Diabetes Association (ADA)-recommended goals in Chinese with type 2 diabetes stratified by body mass index (BMI).
This cross-sectional study enrolled 520 Chinese with type 2 diabetes to find out if they had attained the following ADA-recommended goals: HbA1c<7%, SBP<130 mm Hg, DBP<80 mm Hg, LDL-C<100mg/dl, TG<150 mg/dl, HDL-C>40 mg/dl for men and >50mg/dl for women.
Only 44.4% of all participants achieved the blood pressure goal, 20.8% the HbA1c goal, 44.8% the LDL-C goal, 43.3% the HDL-C goal, and 66.8% the triglyceride goal. Obese patients were less likely than normal weight patients to achieve the blood pressure goal (OR, 0.474; 95% CI, 0.231-0.973; p = 0.01), the HDL goal (OR, 0.365; 95% CI, 0.163-0.817; p = 0.01), or the triglyceride goal (OR, 0.416; 95% CI, 0.212-0.817; p = 0.01), after adjusting for confounders. Compared to normal weight participants, the obese patients had a significantly higher prescription rates for statin, metformin and anti-hypertensive drugs.
Obese diabetic patients were less likely to achieve the blood pressure, LDL-C, HDL-C and triglyceride targets even when they were receiving several drugs to help them meet their target treatment goals. More strategies are needed to improve the treatment of Chinese with type 2 diabetes, particularly those who are obese.

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    ABSTRACT: Hypertension and obesity are known to contribute, directly or indirectly, to the development of long-term complications of type 2 diabetes mellitus (T2DM). Knowing the prevalence of these comorbidities is important for determining the size of the population that may benefit from strategies that reduce blood pressure and weight while controlling blood glucose. In this systematic literature review, electronic searches of PubMed, Embase, and the Cochrane Library were conducted to identify observational studies of hypertension and/or obesity prevalence in patients with T2DM throughout the world. The searches were limited to studies reported in English from January 1, 2001 to February 16, 2012. From a total of 2,688 studies, 92 observational studies provided prevalence rates for hypertension and/or obesity specifically in adults with T2DM. Fifteen studies of specific subtypes of hypertension or subpopulations with T2DM were subsequently excluded, leaving 78 studies (in 77 articles) for inclusion in this article. Of these, 61studies reported hypertension prevalence, 44 reported obesity prevalence, and 12 reported the prevalence of hypertension with obesity. Most studies had a low risk of bias regarding diagnosis of T2DM (70/78), hypertension (59/69), or obesity (45/47). The continental regions with the most observational studies of hypertension or obesity prevalence were Europe (n = 30) and Asia (n = 26). Hypertension rates typically were high in all regions; most studies presented rates above 50%, and many presented rates above 75%. Obesity rates exceeded 30% in 38 of 44 studies and 50% in 14 of 44 studies, especially those assessing central obesity (based on waist circumference). Among obese adults, hypertension rates were at or above 70% in Asia and above 80% in Europe; rates were lower in North and South America but still above 30%. Around the world, hypertension and obesity, separately or together, are common comorbidities in adults with T2DM.
    Full-text · Article · Sep 2013 · Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy