(2.05) Association Between Obesity Indices And Glycemic Control In Type 2 Diabetes Mellitus Patients: A Tertiary Care Hospital Experience From Bangladesh. .

Obesity is a major risk factor for type 2 diabetes (T2DM). Obesity indices such as body mass index (BMI), weight, neck circumference (NC), hip circumference (HC), waist circumference (WC) and waist to hip ratio (WHR) are predictors of diabetes. Weight loss causes a reduction in the progression from impaired glucose tolerance to frank Type 2 diabetes, and reduces mortality in persons with diabetes. The objectives of this study were to determine the obesity indices and their relationship with glycemic control in  type 2 diabetes mellitus patients attending a tertiary care hospital in Dhaka , Bangladesh.

 

Methods:

A cross-sectional, observational study was done among 435 adult type 2 diabetes mellitus (T2DM) patients attending Hormone and Diabetes clinic in a tertiary care hospital, Dhaka, Bangladesh during February 2022 to December 2022. Various anthropometric measurements were used as obesity  indices according to standard World Health Organization (WHO) protocols. Data were gathered on clinical and anthropometric characteristics: fasting blood glucose (FBG), post prandial blood glucose (PPBG) , glycosylated haemoglobin (HbA1c), blood pressure (BP), weight (kg), height (meter), body mass index (BMI), hip circumference(cm) [HC], waist circumference(cm) [WC)], neck circumference(cm) [NC], and waist to hip ratio [WHR].

Results:

The proportion of BMI ≥ 25 kg/m² was 25.3% and 42.5% in male and female subjects respectively [p < 0.05]. The proportion of female subjects with high WC cut-offs ( >80cm) was 90.4% and male subjects (cut-off >90cm) was 48.1%  [p < 0.001]. However, with regard to WHR, 25.9% of the males and only 0.4% of females were at the ideal cut-off points of 0.90 and 0.80 respectively [p < 0.001]. The mean HbA1c  of the participants was 8.60% (± 1.49). Only 8.0% of participants ( male vs. female:4.1% vs. 3.9%) achieved good glycemic control(HbA1c: < 7.0%); [p< 0.05] The correlation between HbA1c level and various obesity indices showed that HbA1c levels were positively correlated with NC [r= 0.443, p< 0.001] and WHR [r= 0.74, p< 0.001] but not correlated with WC, HC or BMI [p > 0.05].

Discussion/Conclusion:

Glycemic control was poor among our study participants. Increased HbA1c was significantly positively correlated with increased  NC and WHR but  not correlated with increased WC, HC or BMI. An aggressive approach should be adopted in managing type 2 diabetes with particular reference of blood glucose and obesity indices. NC and WHR could be used in clinical practice for suggesting life style modifications.