Key result
Among adults with type 2 diabetes and obesity, class 3 obesity was associated with a significantly higher 5-year prevalence of mortality (13.6%) compared to class 1 (9.4%) or class 2 (10.3%).
Why the study?
The study was conducted to examine the prevalence of mortality and morbidity among adults with type 2 diabetes and obesity, both overall and by obesity class.
Cohort (n=15,970)
In adults with type 2 diabetes, class 3 obesity is associated with significantly higher 5-year mortality and cardiovascular/microvascular morbidity compared to class 1 or 2 obesity.
Answers are grounded in this paper and cite their sources.
Class 3 obesity signals higher T2D mortality risk warranting vigilance; leaves open whether weight loss improves outcomes.
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 Optum® 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.
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Boye et al. (2023) conducted a cohort in Type 2 diabetes and obesity (n=15,970). Class 3 obesity (BMI ≥ 40 kg/m2) vs. Class 1 or 2 obesity (BMI 30-39.9 kg/m2) was evaluated on 5-year prevalence of mortality (p=<0.05). Among adults with type 2 diabetes and obesity, class 3 obesity was associated with a significantly higher 5-year prevalence of mortality (13.6%) compared to class 1 (9.4%) or class 2 (10.3%).
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