Prevalence of obesity in type 2 diabetes in secondary care: association with cardiovascular risk factors

Aims: To determine the prevalence of overweight and obesity among patients with type 1 and type 2 diabetes mellitus attending a secondary care diabetes clinic in the United Kingdom, and to assess the impact of overweight and obesity on glycaemic control and cardiovascular risk factors in patients with type 2 diabetes. Methods: 3637 patients with diabetes were identified from the hospital electronic diabetes register, 916 with type 1 diabetes ( mean (SD) age 40.4 ( 15.1) years, 496 male) and 2721 with type 2 diabetes ( mean (SD) age 62.5 (11.8) years, 1436 male). Data on body mass index (BMI), glycaemic control, lipid profiles, and blood pressure were extracted. Results: Of patients with type 1 diabetes, 55.3% were overweight (BMI > 25 kg/m(2)), 16.6% were obese (BMI > 30 kg/m(2)), and 0.4% had morbid obesity (BMI > 40 kg/m(2)). In contrast, 86% of patients with type 2 diabetes were overweight or obese, 52% were obese, and 8.1% had morbid obesity. Obese patients with type 2 diabetes were younger, had poorer glycaemic control, higher blood pressures, worse lipid profiles, and were more likely to be receiving antihypertensive and lipid lowering drugs compared with patients with BMI < 30 kg/m(2). Conclusions: Obesity is the rule among patients attending this hospital diabetes clinic, with 86% of those with type 2 diabetes overweight or obese. Obesity is associated with significantly worse cardiovascular risk factors in this patient group, suggesting that more active interventions to control weight gain would be appropriate.