Zhiting Wang, Piia Lavikainen, Katja Wikström, Tiina Laatikainen
{"title":"Time Trends of Body Mass Index and its Impact on Glycemic Control Among Finnish Patients with Type 2 Diabetes.","authors":"Zhiting Wang, Piia Lavikainen, Katja Wikström, Tiina Laatikainen","doi":"10.1007/s13300-025-01763-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Obesity prevalence has increased in Finland and is prevalent in patients with type 2 diabetes (T2D). Also, hyperglycemia in patients with T2D is partially attributed to obesity. We aimed to examine the time trends of body mass index (BMI) and glycated hemoglobin (HbA1c) control across different BMI categories among Finnish patients with T2D.</p><p><strong>Methods: </strong>Regional data on the electronic health records (EHRs) covering all public healthcare services in North Karelia, Finland, were used to conduct this retrospective study. Annual patients with T2D from 2012 to 2022 were identified from the EHRs. In each study year, patients with ≥ 1 measurement of BMI and HbA1c were included. Linear and logistic regression analyses estimated with generalized estimating equations were performed to evaluate the time trends.</p><p><strong>Results: </strong>The annual number of patients for analyses ranged from 5149 to 10,216 during 2012-2022. The unadjusted mean BMI declined slightly over time but increased after age adjustment (all p < 0.05). In the age-stratified analysis adjusted for sex and diabetes duration, mean BMI increased over time in patients aged 45-64 years (all p < 0.05). Furthermore, the increasing time trend in age-adjusted BMI among the study patients persisted after adjusting for sex, diabetes duration, and antidiabetic medication use (p < 0.05). Overall, patients in the higher BMI categories had higher HbA1c levels and were less likely to achieve the HbA1c target from 2012 to 2022. When examining time trends of HbA1c control, HbA1c control improved over time in patients with the highest level of BMI, coinciding with a greater increase in new antidiabetic medication use compared with the lowest BMI group (p < 0.05 for calendar year × obesity class III interaction).</p><p><strong>Conclusion: </strong>Our findings suggest that weight management requires increased attention among Finnish patients with T2D and is especially important for better glycemic control.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13300-025-01763-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Obesity prevalence has increased in Finland and is prevalent in patients with type 2 diabetes (T2D). Also, hyperglycemia in patients with T2D is partially attributed to obesity. We aimed to examine the time trends of body mass index (BMI) and glycated hemoglobin (HbA1c) control across different BMI categories among Finnish patients with T2D.
Methods: Regional data on the electronic health records (EHRs) covering all public healthcare services in North Karelia, Finland, were used to conduct this retrospective study. Annual patients with T2D from 2012 to 2022 were identified from the EHRs. In each study year, patients with ≥ 1 measurement of BMI and HbA1c were included. Linear and logistic regression analyses estimated with generalized estimating equations were performed to evaluate the time trends.
Results: The annual number of patients for analyses ranged from 5149 to 10,216 during 2012-2022. The unadjusted mean BMI declined slightly over time but increased after age adjustment (all p < 0.05). In the age-stratified analysis adjusted for sex and diabetes duration, mean BMI increased over time in patients aged 45-64 years (all p < 0.05). Furthermore, the increasing time trend in age-adjusted BMI among the study patients persisted after adjusting for sex, diabetes duration, and antidiabetic medication use (p < 0.05). Overall, patients in the higher BMI categories had higher HbA1c levels and were less likely to achieve the HbA1c target from 2012 to 2022. When examining time trends of HbA1c control, HbA1c control improved over time in patients with the highest level of BMI, coinciding with a greater increase in new antidiabetic medication use compared with the lowest BMI group (p < 0.05 for calendar year × obesity class III interaction).
Conclusion: Our findings suggest that weight management requires increased attention among Finnish patients with T2D and is especially important for better glycemic control.
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.