Evaluating the Inter Relationship between Obesity and Diabetes Mellitus Type 2: A Clinical Pilot Study

Research Article

Austin J Nutri Food Sci. 2023; 11(1): 1170.

Evaluating the Inter Relationship between Obesity and Diabetes Mellitus Type 2: A Clinical Pilot Study

Elemi Pavlidou¹; Aristeidis Fasoulas¹; Dimitrios Petridis²; Christina Tryfonos¹; Constantinos Giaginis¹*

¹Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Lemnos, Greece

²Department of Food Technology, Alexander Technological Educational Institute of Thessaloniki, Greece

*Corresponding author: Giaginis Constantinos Professor of Human Human Nutritiom Wellness & Health, Department of Food Science and Nutrition, University of the Aegean, MitropolitiIoakim 2, Myrina, Lemnos, 81440, Greece. Tel: +302254083117; Fax: +302254083109 Email: [email protected]

Received: June 27, 2023 Accepted: July 27, 2023 Published: August 03, 2023


Purpose: This study aims to investigate the effect of anthropometric parameters and clinical indexes on a sample of diabetic patients.

Material and Methods: 440 patients with Type 2 diabetes (T2D), with an average age of 49.9 years, who were selected from a sample of 2.500 cases. Entry criteria for the group were the long-term follow-up period of patients and the repeatability of lab tests.

Results: A strong effect was observed between Body Mass Index (BMI) and hyperglycemia. The frequency of T2D occurrence, was higher in overweight patients (>25 kg/m²) than in those with normal weight (<25 kg/m²). The mean BMI of newly diagnosed diabetic patients was 30.2 Kg/m². There was found a dependence between BMI and sex with the occurrence of cholelithiasis-cholecystitis, with a higher incidence in the class of obese and women. People with normal weight were found to have T2D at a younger age than the other BMI classes that did not differ from each other. Women show higher glucose concentrations than men with normal body weight. At the same BMI class, blood glucose is higher in women than in overweight class. In men no change in glucose was observed at the different BMI classes. The transition of hemoglobin (HbA1c) from step 2 (>7%) to step 1 (<7%) causes a triglyceride concentration reduction of 14.5%. BMI was recorded as the third factor correlated with hyperglycemia, after predisposition and hyperlipidemia and before diastolic blood pressure and age.

Conclusions: At the ascertainment of the newly diagnosed T2D, the presence or not of obesity, determined of BMI, does not affect blood glucose levels in men. In women the normal BMI levels are not deterrent factors of high glucose values, nor age, regardless of gender. BMI is classified as third correlation factor of highglucose values in newly diagnosed diabetics.

Keywords: Diabetes; Obesity; Cholesterol; Triglycerides; Cholelithiasis; Cholecystitis


Diabetes Mellitus (T2D) is one of the most common Non-Communicable Diseases (NCDs) [1] and is the fourth most common cause of death among these diseases (for all ages for both sexes) worldwide [2]. The International Foundation of Diabetes (IDF) estimates that 1 in 11 adults has diabetes (425 million) and 1 in 2 adults with diabetes is undiagnosed (212 million). This number is expected to reach 629 million people with diabetes in the World in 2044 [3].

There are various studies in the international literature, regarding dietary standards related to clinical indicators of diabetes [4] with prevalence of obesity [5,6], but also of the classical risk factors, such as predisposition [7], cardiovascular diseases [8], dyslipidemia [9,10], high blood pressure (hypertension) [11]. And age [12] in diabetic population. Over the years, researchers have studied the relationship between T2D and obesity [13, 14], as well as its various parameters, such as obesity during childhood [15] and teenage age [12], and the distribution of adipose tissue [16, 17]. However, there are few reports on the category of normal weight people and their glucose levels during their first visit and the diagnosis of the disease.

In view of the above considerations, the aim of this study was to prospect all possible effects of BMI on T2D in adults and to examine all relevant factors such as etiology, blood tests and therapeutic interventions both at the first time of the disease diagnosis and during the follow-up period.

Materials and Methods

Study Population

In the context of this research, it was studied, the medical history of 440 patients with type 2 diabetes mellitus with an average age of 49.9 (±13.1) years, 48% women and 52% men with an average disease duration of 11.2 (±8. 8) years.

From demographic-social characteristics, were recorded the sex, age (as of the date of birth), the marital status (married or single), and the profession, which was divided into two categories of physical activity (due to lack of other categories): a) physical activity level (PAL): 1.53 (Sedentary or light activity lifestyle) b) PAL: 1,76 (Active or moderately active lifestyle) (FAO/WHO). The controlled population came from both urban and rural areas.

From the anthropometric characteristics, the present weight, maximum weight and ideal weight were recorded.

From the medical history, was recorded, the time of onset of the disease, the blood pressure (systolic and diastolic), the presence of heart disease, hyperlipidemia (increases in both Cholesterol (Chol.) and Triglycerides (TGs), diabetic angiopathy, cholelithiasis and cholecystitis. In addition, the numbers of births and miscarriages were recorded in women. Also, the family predisposition for T2D (FHD) was recorded, which was divided into 3 categories (none, one and two relatives of first degree, e.g. parent or brother).

Also, the causes that led to the diagnosis of the disease, including: Incidental finding of disease, polyuria, polydipsia, weight loss, acidosis and hyperglycemic and hypoglycemic coma, were also recorded.

From hematological and biochemical laboratory parameters, was recorded, the blood glucose, total Chol., LDL (chol.), HDL (chol.), TGs, urea, uric acid, Haemoglobin (HbA1c), SGOT, SGPT. All of the aforementioned blood tests were performed in the same hospital laboratory, where patients were coming for their planned and systematic medical examination.

Ethics and Morality

The study was conducted according to the guidelines of the international ethical standard of scientific quality for the design, conduct, performance, recording, analyses, and reporting of clinical trials. The ethics of the study protocol was approved by the local committee.

Diagnostic Criteria

In the present study the following diagnostic criteria were used:

For T2D: fasting blood glucose >126 mg/dL and / or 2-hour glucose levels =200 mg/dL, [18] and / or antidiabetic treatment.

For hypercholesterolemia: Total cholesterol >200 mg/dL (Borderline high: 200 to 239 mg/dL) and / or LDL cholesterol >130 mg/dL, and / or Triglycerides: -high: 150 to 199 mg/dL) [19-21] and / or lipid-lowering treatment.

For hypertension: Systolic blood pressure >140 mmHg and / or Diastolic blood pressure >90 mmHg [22,23] and / or antihypertensive treatment.

Statistical Analysis

Continuous variables with normal distribution are presented as mean ± Standard Deviation (SD), while the categorical variables are presented as absolute and relative frequencies (%). Student's analysis was used to evaluate the correlations between categorical and continuous variables following the normal distribution. The statistical control of the significance of the incidence of the disease was done by Chi-square test. The Estimation of the likelihood of occurrence of T2D depending on the parameters of the occurrence of other conditions and symptoms were made based on the calculation of the relative ratios and the corresponding 95% confidence intervals by logarithmic regression analysis. All the values presented are compared to the statistical significance level of 5%. For the calculations, the MINITAB.18 package software was used.


As revealed by the study, the percentage of men and women is almost the same (5.2: 4.8, respectively), most are married (9: 10), with a generally sedentary lifestyle with PAL: 1.53 & PAL: 1.76, in a ratio of 5.2: 4.8 and absence of other categories of greater physical activity.

The 83.5% of this population, upon the first visit and diagnosis of the disease is classified as overweight (BMI >25). In men, 51% belongs to the pre-obesity class (BMI: 25-29.9) and 31% in obesity class (BMI >30), 82% overall. In women, 24% belongs to pre-obesity class and 61% in obesity class (85% overall).

The Family History Diabetes (FHD) (none, one or both of the first-degree relatives) with a ratio of 2.6: 4.3: 3.1 (respectively), seems to predominate. Thus, the final ratio between those who have FHD and those who have not, is 7.4: 2.4.

As major cause of diagnosis of T2D was recorded the incidental finding (56%) and is followed by classic symptoms such as polydipsia (20%), polyuria (13%), and weight loss (7%).

In the medical history during the first visit and diagnosis, increased rates of cardiovascular disease (56%) and diabetic angiopathy (42%) are observed. Also, a significant percentage (62%) shows increased systolic pressure and diastolic pressure (44%). Table 1 presents the comparative analysis of various parameters (such as systolic and diastolic pressure), lipids (cholesterol, triglycerides, HDL, LDL), SGOT, SGPT, Urea, Creatinine, and HbA1c, during the first visit and at one of the subsequent post-treatment visits (at least one year) as part of the repeat check-up at the hospital.