LEADER 5: prevalence and cardiometabolic impact of obesity in cardiovascular high-risk patients with type 2 diabetes mellitus: baseline global data from the LEADER trial

Masmiquel, Luis; Leiter, Lawrence A.; Vidal, Josep; Bain, Stephen C.; Petrie, John R.; Franek, Edward; Raz, Itamar; Çömlekçi, Abdurrahman; Jacob, Stephan; Gaal, Luc Van; Baeres, Florian M.M.; Marso, Steven P.; Eriksson, Mats

doi:10.1186/s12933-016-0341-5

Cited by 53 publications

(38 citation statements)

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“…Women with type 2 diabetes have a 2.5 times greater risk of obesity than men and have a 16.5% prevalence of severe obesity. With these numbers, Turkish women with type 2 diabetes appear to have the highest risk of obesity when compared to other studies from different regions of the world [10, 22, 24-26]. Obesity is already a significant problem in non-diabetic Turkish women as well [16].…”

Section: Discussionmentioning

confidence: 87%

“…Smoking and body weight is inversely related [27, 28], probably due to the reduction in food intake and increased metabolic rate in smokers [29]. Weight gain after smoking cessation is well reported [10, 30]. Still, the effect of smoking on mortality and morbidity is much higher than the effect of obesity [31, 32], notwithstanding being an independent risk factor for type 2 diabetes [33].…”

Section: Discussionmentioning

confidence: 99%

“…Characterizing the sociodemographic features of patients with type 2 diabetes and obesity will help to better understand the issue in Turkey. Large multinational studies report the prevalence of obesity as 53–62% in patients with type 2 diabetes [10, 22, 23]. The TEMD Obesity Study shows that Turkey is among the countries with the highest prevalence of obesity in patients with type 2 diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…This is most likely due to the survivor bias. Obese patients have a greater likelihood of dying than those with a lower BMI [10, 25]. Another significant aspect of TEMD patients with obesity is the low smoking prevalence.…”

Section: Discussionmentioning

confidence: 99%

“…Obesity is also a significant hurdle in diabetes management and an independent risk factor for cardiovascular diseases [4, 9]. The prevalence of obesity varies in different regions of the world and there is hardly enough data about the effects of obesity on the achievement of metabolic targets in patients with type 2 diabetes [10]. …”

Section: Introductionmentioning

confidence: 99%

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Impact of Obesity on the Metabolic Control of Type 2 Diabetes: Results of the Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Obesity Study)

et al. 2019

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Background: Obesity is the main obstacle for metabolic control in patients with type 2 diabetes. Turkey has the highest prevalence of obesity and type 2 diabetes in Europe. The effect of obesity on the metabolic control, and the macro- and microvascular complications of patients are not apparent. Objectives: This nationwide survey aimed to investigate the prevalence of overweight and obesity among patients with type 2 diabetes and to search for the impact of obesity on the metabolic control of these patients. We also investigated the independent associates of obesity in patients with type 2 diabetes. Methods: We consecutively enrolled patients who were under follow-up for at least 1 year in 69 tertiary healthcare units in 37 cities. The demographic, anthropometric, and clinical data including medications were recorded. Patients were excluded if they were pregnant, younger than 18 years, had decompensated liver disease, psychiatric disorders interfering with cognition or compliance, had bariatric surgery, or were undergoing renal replacement therapy. Results: Only 10% of patients with type 2 diabetes (n = 4,648) had normal body mass indexes (BMI), while the others were affected by overweight (31%) or obesity (59%). Women had a significantly higher prevalence of obesity (53.4 vs. 40%) and severe obesity (16.6 vs. 3.3%). Significant associations were present between high BMI levels and lower education levels, intake of insulin, antihypertensives and statins, poor metabolic control, or the presence of microvascular complications. Age, gender, level of education, smoking, and physical inactivity were the independent associates of obesity in patients with type 2 diabetes. Conclusion: The TEMD Obesity Study shows that obesity is a major determinant of the poor metabolic control in patients with type 2 diabetes. These results underline the importance of prevention and management of obesity to improve health care in patients with type 2 diabetes. Also, the results point out the independent sociodemographic and clinical associates of obesity, which should be the prior targets to overcome, in the national fight with obesity.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of Obesity on the Metabolic Control of Type 2 Diabetes: Results of the Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Obesity Study)

et al. 2019

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Cardio‐renal‐metabolic disease in primary care setting

Ibrahim,

Ba‐Essa,

Baker

et al. 2023

Diabetes Metabolism Res

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In the primary care setting providers have more tools available than ever before to impact positively obesity, diabetes, and their complications, such as renal and cardiac diseases. It is important to recognise what is available for treatment taking into account diabetes heterogeneity. For those who develop type 2 diabetes (T2DM), effective treatments are available that for the first time have shown a benefit in reducing mortality and macrovascular complications, in addition to the well‐established benefits of glucose control in reducing microvascular complications. Some of the newer medications for treating hyperglycaemia have also a positive impact in reducing heart failure (HF). Technological advances have also contributed to improving the quality of care in patients with diabetes. The use of technology, such as continuous glucose monitoring systems (CGM), has improved significantly glucose and glycated haemoglobin A1c (HbA1c) values, while limiting the frequency of hypoglycaemia. Other technological support derives from the use of predictive algorithms that need to be refined to help predict those subjects who are at great risk of developing the disease and/or its complications, or who may require care by other specialists. In this review we also provide recommendations for the optimal use of the new medications; sodium‐glucose co‐transporter‐2 inhibitors (SGLT2i) and Glucagon‐like peptide‐receptor agonists 1 (GLP1RA) in the primary care setting considering the relevance of these drugs for the management of T2DM also in its early stage.

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Weight changes following antidiabetic mediation use: Real‐world evidence from health system data

Lyu

Grams

Inker

et al. 2022

Obesity Science & Practice

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Objective: Newer antidiabetic medications such as sodium-glucose co-transporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP1RA) result in weight loss in clinical trials. However, the real-world effectiveness remains unclear.The magnitude of weight change associated with antidiabetic medication using realworld data was examined.Methods: Patients with diabetes who initiated SGLT2i (n = 906), GLP1RA (n = 782), dipeptidyl peptidase-4 inhibitors (DPP4i, n = 1881), or sulfonylureas (n = 3255) in Geisinger Health System were identified. Outcomes were percent weight change per year and time to 5% weight loss. Propensity scores were used to account for differences across groups. Results:The mean � SD age of patients was 57.5 � 14.1 years, 3381 (49.5%) were female, and 6450 (94.5%) had body mass index ≥25 kg/m 2 . Compared with sulfonylureas, newer antidiabetic medications were associated with significant weight loss (−3.2% [95% confidence interval: −3.8%, −2.6%] per year for SGLT2i; −2.9%[−3.6%, −2.3%] per year for GLP1RA; and −1.7% [−2.1%, −1.3%] per year for DPP4i). SGLT2i and GLP1RA were also associated with significant weight loss compared with DPP4i. Among patients with overweight or obesity, SGLT2i and GLP1RA users were more likely to achieve 5% weight loss compared with sulfonylureas and DPP4i. Conclusions:In real-world practice, SGLT2i and GLP1RA were associated with significant weight loss compared with sulfonylureas and DPP4i. These results may further motivate uptake of SGLT2i and GLP1RA, especially among patients who were overweight or had obesity.

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LEADER 5: prevalence and cardiometabolic impact of obesity in cardiovascular high-risk patients with type 2 diabetes mellitus: baseline global data from the LEADER trial

Cited by 53 publications

References 50 publications

Impact of Obesity on the Metabolic Control of Type 2 Diabetes: Results of the Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Obesity Study)

Impact of Obesity on the Metabolic Control of Type 2 Diabetes: Results of the Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Obesity Study)

Cardio‐renal‐metabolic disease in primary care setting

Weight changes following antidiabetic mediation use: Real‐world evidence from health system data

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