The Association Between Obesity and the 5-Year Prevalence of Morbidity and Mortality Among Adults with Type 2 Diabetes

Abstract

Introduction: This retrospective claims database study examined the prevalence of mortality and morbidity among adults with type 2 diabetes (T2D) and obesity. Methods: The study used deidentified data from 2007 to 2021 from the OptumÒ Market Clarity Dataset. A cohort of adults with T2D and obesity were identified, and age-and sex-adjusted prevalence rates were calculated for mortality, a composite cardiovascular outcome (CCO), a composite microvascular outcome (CMO), and other complications. Results were examined overall and by obesity class (class 1, class 2, and class 3).Results: For the 15,970 adults included in the study, the prevalence of CCO and CMO after 5 years was 15.3% and 60.7%, respectively. The 5-year prevalence of mortality was 10.9%. There were statistically significant differences in prevalence rates by obesity class, with obesity class 3 associated with higher rates of morbidity and mortality compared to obesity classes 1 or 2. Specifically, after 5 years, the prevalence of mortality was 9.4%, 10.3% and 13.6% for obese classes 1, 2 and 3, respectively (P \ 0.05 between class 3 and class 2 or 1). Similarly, For obesity classes 1, 2 and 3, the 5-year prevalence of CCO was 13.0%, 14.5% and 18.4% and the rates for CMO were 58.0%, 57.9% and 64.8%, respectively (both P \ 0.05 between class 3 and class 2 or 1). Regarding other complications, differences in the prevalence of atherosclerotic cardiovascular disease (ASCVD) and obstructive sleep apnea (OSA) were statistically significantly higher with increasing obesity class. Conclusions:The results indicate that for a cohort of adults with T2D and obesity, obesity class 3 is associated with significantly higher mortality and morbidity, including CCO, CMO, ASCVD and OSA. These findings suggest that treatment which reduces obesity among individuals with T2D may have significant health benefits, although additional studies are needed to confirm the results.

Cross-walk of the Chronic Liver Disease Questionnaire for Nonalcoholic Steatohepatitis (CLDQ-NASH) and the EuroQol EQ-5D-5L in patients with NASH

“…Both models performed better in non-obese versus obese patients, and in patients who did not have T2D versus those who did. This is likely a result of obese patients and those with T2D having greater variability in EQ-5D-5L values because of the range of complications that frequently exist in individuals with these conditions [ 40 , 41 ], and the coexistence of obesity and T2D in many patients [ 42 ]. We observed that the two best models performed less well at predicting lower versus upper values of EQ-5D-5L.…”

Current Discoveries and Future Implications of Eating Disorders

“…In addition, an estimated 41 million children under the age of five are overweight or obese. It was reported that obesity is a major risk factor for premature mortality [62,63]. In addition, obesity is associated with a higher risk of developing several chronic conditions that can lead to premature death, such as cardiovascular disease, type II diabetes, and some cancers [64,65].…”

Behavioral Lifestyle Interventions for Weight Loss in Overweight or Obese Patients with Type 2 Diabetes: A Systematic Review of the Literature

“…Overweight and obesity are associated with metabolic syndrome [ 2 ] and represent major risk factors for the development of type 2 diabetes mellitus (T2DM) [ 1 – 3 ]. The prevalence of T2DM increases linearly with body mass index (BMI) [ 4 – 7 ], and around 80–90% of diabetic patients are overweight or obese [ 8 ], presenting a greater risk for serious health complications and mortality [ 2 , 8 , 9 ].…”

“…Behavioral lifestyle interventions often involve a combination of dietary, physical activity, and behavioral components, which involve strategies to promote changes in diet and physical activity [ 7 , 15 – 17 ]. Although these interventions have a positive impact on physical health and quality of life [ 9 , 15 , 18 , 19 ], evidence about their efficacy in terms of weight loss is still controversial [ 10 , 19 – 24 ] and results are difficult to maintain in the long term [ 25 , 26 ].…”