Hormonal
In high-risk type 2 diabetes patients, higher BMI and waist circumference are significantly associated with worse cardiometabolic control (higher triglycerides, lower HDL-C, higher blood pressure) and higher medication intensity, despite these patients receiving more aggressive lipid and blood pressure therapy.
For patients with T2DM and high heart risk, carrying excess weight (high BMI or waist circumference) is strongly linked to harder-to-control blood pressure, cholesterol, and blood sugar, even when doctors prescribe more medication. Addressing adiposity is critical because it correlates with better control of these major risk factors.
Obesity was associated with being younger, female, previous smoker, Caucasian, American, with shorter diabetes duration, uncontrolled blood pressure (BP), antihypertensive agents, insulin plus oral antihyperglycaemic treatment, higher levels of triglycerides and lower levels of high-density lipoprotein cholesterol.
Why this rating
Large sample size (n=9340), rigorous statistical modeling (multivariable logistic regression), but cross-sectional baseline data limits causal inference.
Source
LEADER 5: prevalence and cardiometabolic impact of obesity in cardiovascular high-risk patients with type 2 diabetes mellitus: baseline global data from the LEADER trial
on behalf of the LEADER investigators et al. · Cardiovascular Diabetology · 2016
DOI 10.1186/s12933-016-0341-5
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