Glycemic control of newly-diagnosed type 2 diabetes with different baseline body mass index under the standardized metabolic disease management model / 中华内分泌代谢杂志

ABSTRACT

Objective To explore the glycemic control of newly-diagnosed type 2 diabetes with different levels of baseline body mass index ( BMI ) after 6 months treatment under the standardized metabolic disease management model. Methods ( 1) 163 patients of newly-diagnosed type 2 diabetes were divided into normal weight (BMI 18.5-23.9 kg/m2), overweight (BMI 24.0-27.9 kg/m2), and obese (BMI≥28 kg/m2) groups according to baseline BMI, the blood glucose and lipids levels were compared among 3 groups. ( 2) The blood glucose levels were compared among 3 groups after 6 months of standardized management. ( 3) The overweight and obese patients were divided into group weight loss≥5％and group weight loss<5％ or weight gain in 6 months. The blood glucose levels were compared. Results ( 1) At baseline, overweight and obese groups had higher homeostasis model assessment for insulin resistance and lower high density lipoprotein-cholesterol compared with normal weight group. ( 2) After 6 months of treatment, HbA1C and HbA1C reduction showed no difference among 3 groups ( normal, overweight and obese) after adjusted by baseline HbA1C. The rate of HbA1C<7％among 3 groups were 77.78％, 83.95％, and 80.43％(P>0.05). (3) After 6 months of treatment, 32.28％ overweight and obese patients lost weight by ≥5％, while HbA1C and HbA1C reduction showed no difference between 2 groups ( weight loss≥5％and weight gain or weight loss<5％) after adjusted by baseline HbA1C. Both groups achieved good glycemic control [(6.27±1.38 vs 6.43±0.66)％], but have no significantly(P>0.05). Group weight loss≥5％ had better glucose control (92.68％ vs 77.91％, P<0.05) . Conclusions As BMI increased, insulin resistance and lipid disorders were more serious in newly-diagnosed type 2 diabetes. After 6 months of standardized metabolic management, newly-diagnosed type 2 diabetes with different baseline BMI and weight changes both achieved good glycemic control. In addition, patients losing weight equal to or more than 5％achieved higher attainment of HbA1C targets.