Clinical Profile of Type 2 Diabetes Mellitus And Body Mass Index - Is There Any Correlation?

BACKGROUND: Obesity in Type 2 Diabetes is uncommon in Indian population, compared to western population. Markers of obesity are Body mass index (BMI) & waist Hip ratio (WHR). Does BMI by current definition will correlate well with diabetes related complications in Indian Diabetic population? AIM: To study clinical profile and complications among four groups of cases of type 2 diabetes classified based on BMI Lean, Normal weight, Over-weight, and Obese Diabetics. SETTING & DESIGN: Diabetes clinic Dr TMA Pay Hospital, Udupi attached to K M C Manipal. Descriptive case series analysis of 500 serial type 2 diabetics MATERIALS & METHODS: 500 Type 2 diabetic patients from Diabetic clinic between July 2000 to January 2001 divided into 4 groups based on body mass index (BMI) were our study subjects. Detailed clinical examination and screening for micro/macro vascular complications was done in all patients RESULTS: Lean diabetics were 7.4%. Majority of diabetics had normal weight (65%). 24% belonged to overweight group; only2.6% of diabetics were obese. Incidence of hypertension in lean diabetic was 16.2%, whereas it was 38.8% in normal weight diabetics 42% in over weight diabetics and 61.5% in obese diabetics. The incidence of ischemic heart disease (I.H.D) was very low in lean diabetics (2.7%); it was 13.88% in normal weight diabetics, 12% in over weight diabetics and 23% in obese diabetics. As body mass increases, the prevalence of macro vascular complications was increasing. But micro vascular complications prevalence was similar in all groups. Fasting and postprandial sugar levels were significantly higher in lean diabetics. Lean diabetics had significantly favorable lipid profile compared to other groups. CONCLUSIONS: Obesity as defined body mass index is uncommon in Indian context.