Obesity and glycemic control among people with type 2 diabetes in the United States: A retrospective cohort study using insurance claims data

Aims: To examine body mass index (BMI) and HbA1c for individuals with type 2 diabetes (T2D) in the United States. Methods: The retrospective study utilized data from IBM (R) MarketScan (R) Explorys (R) Claims-EMR Data for the years 2012-2019. Individuals with T2D and a recorded HbA1c laboratory result and BMI were included. The relationship between BMI and HbA1c was assessed descriptively and logistic regressions examined the relationship between benchmark BMI and the probability of having HbA1c above targets of 7% or 8% in the 1 year post-period. Results: In our sample of 44,723 patients, results indicated that compared to individuals of normal weight, those classified as obese class I or obese class II were 24% more likely to have a last HbA1c > 7% (Odds Ratio [OR] = 1.24; 95% Confidence Interval [CI] 1.14-1.35 for both obese class I and obese class II), while those classified as obese class III were 16% more likely (OR = 1.16; 95% CI 1.06-1.27). Results were similar when using a HbA1c threshold of 8%. Conclusions: Given the importance of glycemic control for people with T2D, these results suggest that treatments which reduce rates of obesity may help to improve health outcomes.