Glycemic Control and Obesity Among People With Type 2 Diabetes in Europe and Australia: A Retrospective Cohort Analysis

IF 3.8 3区医学 Q2 Medicine

Diabetes Therapy Pub Date : 2024-04-29 DOI:10.1007/s13300-024-01583-w

Rachel S. Newson, Victoria Divino, Kristina S. Boye, Justin Chen, Mitch DeKoven, Carlos Vallarino, Kari Ranta, Julie E. Mount

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Abstract

Introduction

In people with type 2 diabetes (PwT2D) who also have obesity, efforts targeting weight loss, including lifestyle, medication and surgical interventions, are recommended. The objective of this study was to explore the relationship between glycemic control and obesity among PwT2D in Europe and Australia using recent real-world data and applying consistent methodology across countries.

Methods

Retrospective study utilizing IQVIA electronic medical records (EMR) databases grouped into panels based on specialty of contributing physicians. General practitioner (GP) and endocrinologist/diabetologist (E/D) panels were used in Germany and France, while GP panels were used in Italy, UK and Australia. The Spanish database included all physician specialties. The sample included PwT2D with glycated hemoglobin A1c (HbA1c) and body mass index (BMI) values measured within 90 days of each other between January 2015 and December 2018 (second record termed the ‘index date’). PwT2D had a 1-year baseline period and a recorded HbA1c at the end of the 1-year post-index period.

Results

The final sample comprised 194,729 PwT2D. At baseline, across countries/panels, 36.8–58.0% were above HbA1c target (HbA1c ≥ 7%) and 39.4–56.7% had obesity (BMI ≥ 30.0 kg/m²). Mean HbA1c ranged from 6.9 to 7.6% and mean BMI ranged from 29.3–31.6 kg/m². At baseline, a higher proportion of PwT2D with obesity (40.8–64.2%) were above HbA1c target compared to their counterparts without obesity (32.2–52.4%). A higher proportion of patients with obesity at baseline (38.1–60.6%) had post-index HbA1c above target compared to their counterparts without obesity (30.9–56.0%). In logistic regression, patients with obesity had substantially lower odds of post-index HbA1c below target compared to those without obesity in all countries/panels except for France (E/D), Spain and Australia.

Conclusions

This study presents data on HbA1c and BMI among type 2 diabetes (T2D) populations in Europe and Australia. A notable proportion of PwT2D had obesity and were above HBA1c target. Higher BMI was associated with poorer glycemic control.

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欧洲和澳大利亚 2 型糖尿病患者的血糖控制与肥胖：回顾性队列分析

导言对于同时患有肥胖症的 2 型糖尿病患者（PwT2D），建议采取减肥措施，包括生活方式、药物和手术干预。本研究的目的是利用最新的真实世界数据，并采用各国一致的方法，探讨欧洲和澳大利亚 2 型糖尿病患者的血糖控制与肥胖之间的关系。德国和法国采用全科医生 (GP) 和内分泌/糖尿病医生 (E/D) 面板，意大利、英国和澳大利亚采用全科医生面板。西班牙数据库包括所有专科医生。样本包括在 2015 年 1 月至 2018 年 12 月期间（第二个记录称为 "索引日期"）90 天内测量过糖化血红蛋白 A1c (HbA1c) 和体重指数 (BMI) 值的 PwT2D。PwT2D 有 1 年的基线期，并在指数后 1 年期结束时记录 HbA1c。结果最终样本包括 194729 名 PwT2D。在基线期，各国/各小组中有 36.8-58.0% 的人 HbA1c 超过目标值（HbA1c ≥ 7%），39.4-56.7% 的人患有肥胖症（BMI ≥ 30.0 kg/m2）。平均 HbA1c 为 6.9% 至 7.6%，平均 BMI 为 29.3-31.6 kg/m2。与没有肥胖症的患者（32.2%-52.4%）相比，基线时有肥胖症的 2 岁以下儿童（40.8%-64.2%）的 HbA1c 高于目标值的比例更高。与无肥胖症患者（30.9-56.0%）相比，基线肥胖症患者（38.1-60.6%）的指标后 HbA1c 高于目标值的比例更高。在逻辑回归中，除法国（E/D）、西班牙和澳大利亚外，在所有国家/小组中，肥胖患者的指数后 HbA1c 低于目标值的几率大大低于非肥胖患者。2型糖尿病患者中肥胖和 HbA1c 高于目标值的比例很高。体重指数越高，血糖控制越差。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.90

自引率

7.90%

发文量

130

审稿时长

6 weeks

期刊介绍： Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.