Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2019;12(2):167-178.
doi: 10.1159/000496624. Epub 2019 Mar 20.

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)

Alper Sonmez  1 , Volkan Yumuk  2 , Cem Haymana  3 , Ibrahim Demirci  3 , Cem Barcin  4 , Sinem Kıyıcı  5 , Sibel Güldiken  6 , Gonca Örük  7 , Basak Ozgen Saydam  8 , Süleyman Baldane  9 , Faruk Kutlutürk  10 , Ferit Kerim Küçükler  11 , Oğuzhan Deyneli  12 , Berrin Çetinarslan  13 , Tevfik Sabuncu  14 , Fahri Bayram  15 , Ilhan Satman  16 ; TEMD Study Group
Affiliations
Multicenter 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)

Alper Sonmez et al. Obes Facts. 2019.

Abstract

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.

Keywords: Blood pressure; HbA1c; Lipid metabolism; Obesity; Type 2 diabetes.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Distribution of patients with type 2 diabetes according to gender and BMI categories.
Fig. 2
Fig. 2
Achievement of metabolic targets according to the BMI categories.
Fig. 3
Fig. 3
The independent associates of being a patient with type 2 diabetes and obesity.
See this image and copyright information in PMC

References

    1. Langenberg C, Sharp SJ, Schulze MB, Rolandsson O, Overvad K, Forouhi NG, et al. InterAct Consortium Long-term risk of incident type 2 diabetes and measures of overall and regional obesity: the EPIC-InterAct case-cohort study. PLoS Med. 2012;9((6)):e1001230. - PMC - PubMed
    1. Mamtani M, Kulkarni H, Dyer TD, Almasy L, Mahaney MC, Duggirala R, et al. Waist circumference independently associates with the risk of insulin resistance and type 2 diabetes in mexican american families. PLoS One. 2013;8((3)):e59153. - PMC - PubMed
    1. Verma S, Hussain ME. Obesity and diabetes: an update. Diabetes Metab Syndr. 2017 Jan-Mar;11((1)):73–9. - PubMed
    1. Joshi AV, Day D, Lubowski TJ, Ambegaonkar A. Relationship between obesity and cardiovascular risk factors: findings from a multi-state screening project in the United States. Curr Med Res Opin. 2005 Nov;21((11)):1755–61. - PubMed
    1. Health Effects of Overweight and Obesity in 195 Countries. N Engl J Med. 2017 Oct;377((15)):1495–7. - PubMed

Publication types

MeSH terms