In the Journals

BMI did not hinder recommended screenings in patients with diabetes

BMI was not a barrier to care for recommended screenings and examinations among overweight and obese patients with diabetes, according to findings published in the American Journal of Managed Care.

“We found that those individuals who were overweight and obese were more likely than their healthy-weight counterparts to have the recommended screening tests and examinations performed but were less likely to have their glucose and BP controlled. Interestingly, we found the opposite for LDL [cholesterol] control, which increased with increasing BMI,” researchers wrote.

Patients with diabetes (n=164,721; mean age, 56.9 years; mean BMI, 32.4) were categorized as healthy-weight (12%), overweight (30%), obese class I (28%), II (17%) and III (14%), according to data.

Only 41% of the patients attained an HbA1c level of <7%, whereas 58% attained the LDL goal of <2.6 mmol/L, 82% reached the BP goal of <140 mm Hg/90 mm Hg, and 54% reached the BP goal of <130 mm Hg/80 mm Hg, according to data.

After adjustments for comorbidities, data indicated that overweight and obese patients were more likely to have all four screening measures (HbA1c, retinal examination, nephropathy screening, and lipid screening) compared with their healthy-weight controls.

However, the likelihood that a patient underwent a retinal examination did not consistently increase with increasing BMI (P=.441), researchers wrote. They attributed this result to the ophthalmologist being outside the patient’s normal routine of care.  

Overweight (OR=1.17; 95% CI, 1.08-1.27) and obese class I (OR=1.44; 95% CI, 1.32-1.57), II (OR=1.62; 95% CI, 1.48-1.78) and III (OR=1.84; 95% CI, 1.66-2.04) patients were more likely to be screened for nephropathy compared with healthy-weight controls (P<.0001), according to data.

Once adjustments were made, it appeared as though overweight and obese patients were less likely to have optimal glycemic control (HbA1c <7%) and BP control (<130 mm Hg/80 mm Hg) compared with healthy-weight controls.

Conversely, LDL control tended to increase across all BMI categories, with class III patients being more likely (OR=1.23; 95% CI, 1.17-1.29) to reach their goal compared with healthy-weight controls.

These data highlight the need for interventions to improve glycemic and blood pressure control among patients who are overweight and obese with diabetes, the researchers said.

Disclosure: The researchers report no relevant financial disclosures.

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