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

Abstract

Introduction: Obesity is defined for the Asian population as a body mass index (BMI) >25 kg/m2, while overweight is a BMI between 23 kg/m2 and 24.9 kg/m2. 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.