The association of weight status with glycemic control, diabetes related complications and anti-hyperglycemic medication use in patients with type 2 diabetes mellitus: The results of the Australian National Diabetes Audit (ANDA) 2015-2022.

AIMS: Type 2 diabetes has reached pandemic proportions; and obesity is considered one of its main drivers. We investigated the association of weight status with glycemic control, diabetes related complications and anti-hyperglycemic medication use among adults living with type 2 diabetes mellitus (T2DM).

METHODS

We analysed data from the 2015 to 2022 cross-sectional Australian National Diabetes Audits (ANDA) to explore the association of weight status with glycemic control and diabetes complications.

RESULTS

13,589 adult patients with T2DM (55.7 % male, mean body mass index 33.4 kg/m2) were included. 71 % of patients had above-target glycemia (HbA1c > 7 %). Odds of being moderately above target (HbA1c 7.1-9 %) or greatly above target (HbA1c > 9 %) were higher in patients with obesity (OR 1.20, 95 % CI 1.05, 1.37 and OR 1.43 95 % CI 1.22, 1.68 respectively). Patients with obesity were more likely to have cardiovascular disease, diabetic foot ulcers and peripheral vascular disease, despite use of a greater number of anti-hyperglycemic drugs.

CONCLUSIONS

Patients with T2DM and obesity have poorer glycemic control, higher utilisation of anti-glycemic medications and greater odds of diabetes related complications. Approaches to optimise glycemic control that also deliver weight reduction should be an integral component of diabetes management to help improve health outcomes for people with T2DM.