Microvascular and macrovascular complications in non-obese/overweight and obese/overweight type 2 diabetes mellitus

Digvijay Chavan, Nilesh Lomte, Meenakshi Bhattacharya, Akash Singh, Ramachandra Sonavale
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Abstract

Introduction: Obesity is defined for the Asian population as a body mass index (BMI) >25 kg/m 2 , while overweight is a BMI between 23 kg/m 2 and 24.9 kg/m 2 . Both obesity and type 2 diabetes are major independent risk factors for cardiovascular disease according to previous literature. The data on the risk of obesity on diabetic complications are scarce, which is why this study was conducted. This study is designed to study the hypothesis that complications of diabetes are more in obese/overweight than in non-obese patients. Materials and Methods: We conducted an observational cross-sectional study in a tertiary care center. Patients with known type 2 diabetes mellitus admitted to our center were serially selected and BMI was calculated and patients were divided into non-obese/overweight and obese/overweight categories according to the World Health Organization recommendations for the Asian population. Patients were assessed for diabetes control and duration of diabetes. Each patient was also evaluated for microvascular and macrovascular complications of diabetes according to the American diabetes association guidelines. Complications in obese/overweight diabetics and diabetics with normal BMI were compared. SPSS version 23 software was used for statistical analysis. Results: A total of 84 admitted diabetics were included, of the 84 patients 45 (53.57%) were women, and 56 (66.67%) were overweight and obese. About 10.71% of diabetics with normal BMI and 26.79% of overweight/obese diabetics had retinopathy. 8 (28.57%) patients in the normal BMI group, while 26 (46.42%) patients in the overweight/obese group had ischemic heart disease (IHD) ( P < 0.05). Conclusion: Obesity and overweight are associated with a high risk of complications of diabetes, especially retinopathy and IHD. Glycemic control is also poor among obese/overweight diabetics. Microvascular complications occur earlier in obese/overweight diabetics.
非肥胖/超重和肥胖/超重2型糖尿病的微血管和大血管并发症
亚洲人口的肥胖定义为身体质量指数(BMI)为25 kg/ m2,而超重定义为BMI在23 kg/ m2至24.9 kg/ m2之间。既往文献显示,肥胖和2型糖尿病都是心血管疾病的主要独立危险因素。关于肥胖对糖尿病并发症的风险的数据很少,这就是进行这项研究的原因。本研究旨在研究肥胖/超重患者比非肥胖患者更容易出现糖尿病并发症的假设。材料和方法:我们在一家三级保健中心进行了一项观察性横断面研究。对我院收治的已知2型糖尿病患者进行序列选择,计算BMI,并根据世界卫生组织对亚洲人群的推荐标准将患者分为非肥胖/超重和肥胖/超重两类。评估患者的糖尿病控制和糖尿病持续时间。根据美国糖尿病协会指南,对每位患者的微血管和大血管并发症进行评估。比较肥胖/超重糖尿病患者与BMI正常糖尿病患者的并发症。采用SPSS 23版软件进行统计分析。结果:共纳入84例住院糖尿病患者,其中女性45例(53.57%),超重和肥胖56例(66.67%)。约10.71% BMI正常的糖尿病患者和26.79%超重/肥胖的糖尿病患者有视网膜病变。BMI正常组8例(28.57%),超重/肥胖组26例(46.42%)发生缺血性心脏病(IHD) (P <0.05)。结论:肥胖和超重与糖尿病并发症的高风险相关,尤其是视网膜病变和IHD。肥胖/超重的糖尿病患者血糖控制也很差。微血管并发症在肥胖/超重糖尿病患者中发生得更早。
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