Key result
Elevated triglycerides linked to ~6-fold higher odds of multisystem complications in controlled T2D.
Why the study?
Do hypertriglyceridemia and obesity drive multisystem complications in type 2 diabetes patients with well-controlled HbA1c?
Cross-Sectional (n=400)
Do hypertriglyceridemia and obesity drive multisystem complications in type 2 diabetes patients with well-controlled HbA1c?
Odds Ratio: 6.24 (95% CI 2.84–13.71)
p-value: p=<0.001
In type 2 diabetes patients with optimal HbA1c (<7%), hypertriglyceridemia and obesity remain significant drivers of multisystem complications, highlighting the need for comprehensive metabolic screening beyond glucose control.
Introduction and Objective: Achieving HbA1c <7% is considered as good control yet many well-controlled diabetes patients develop complications. We investigated complication prevalence among diabetics meeting glycemic targets to identify missed high-risk patients and determine metabolic drivers of complications despite optimal HbA1c in community-based type 2 diabetes. Methods: Analysis of 400 T2DM patients from screening camps. Among 168 with HbA1c 7% (mean 6.4±0.4%), assessed Bone density (NORMAL/OSTEOPENIA/OSTEOPOROSIS), Neuropathy(NORMAL/MILD/MODERATE/SEVERE), Dyslipidemia (TG>150, LDL>100, HDL< 40/50). Multisystem-complication: ≥2 systems affected. Compared complication-free versus multi system-complication patients using t-tests and logistic regression. Results: Among 168 HbA1c <7% patients, 74 (44%) had multisystem-complications despite optimal control. Breakdown: bone loss 58%, neuropathy 35%, dyslipidemia 62%. Patients with versus without multisystem-complications: triglycerides 198 vs 118 mg/dL (p<0.001), BMI 29.8 vs 24.2 (p<0.001), HbA1c identical (6.4% vs 6.3%, p=0.68). TG>200 conferred 6.2-fold odds (OR 6.24, CI 2.84-13.71, p<0.001), BMI >28 conferred 4.8-fold odds (OR 4.78, CI 2.31-9.89, p<0.001). Combined TG >200 + BMI>28: 82% complications versus TG<150 + BMI<25: 12% (p< 0.001). Among excellent HbA1c 6% (n=42), 38% had multi-complications, all with TG>180 or BMI>27. Conclusion: Forty-four percent of diabetics achieving HbA1c<7% harbor multi-system complications driven by hypertriglyceridemia and obesity. Optimal HbA1c provides false reassurance while elevated triglycerides and BMI damage organs. Findings mandate comprehensive metabolic screening regardless of HbA1c, challenging glucose-centric paradigm and redefining “good control”. Disclosure S. Patil: None.
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SHUBHASHREE PATIL (2026) conducted a cross-sectional in Type 2 Diabetes (n=400). Hypertriglyceridemia (Triglycerides >200 mg/dL) vs. Patients without hypertriglyceridemia was evaluated on Multisystem-complications (≥2 systems affected among bone density, neuropathy, and dyslipidemia) (OR 6.24, 95% CI 2.84-13.71, p=<0.001). In type 2 diabetes patients with optimal HbA1c <7%, elevated triglycerides (>200 mg/dL) significantly increased the odds of multisystem complications (OR 6.24; 95% CI 2.84-13.71; P<0.001).
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