Twenty-year trend of increasing obesity in young patients with poorly controlled type 2 diabetes at first diagnosis in urban Japan

Aims/IntroductionTo investigate trends over the past 20years for the prevalence of obesity and glycemic control in association with a patient's first hospital visit for type 2 diabetes mellitus. Materials and MethodsThis was a historical, cross-sectional, time-series, single-center study carried out at Marunouchi Hospital. Data from type 2 diabetic patients who were never treated until their first hospital visit were analyzed for the following periods: 1986-1987 (group A, n=453), 1996-1997 (group B, n=547) and 2006-2008 (group C, n=443). Data on each patient's body mass index (BMI), age, untreated duration and glycated hemoglobin levels were also collected. ResultsObesity in younger patients (below age 40years and ages 40-49years in group C) with poor glycemic control increased over time. Patients with a BMI of <21.0kg/m(2) or 23.0kg/m(2) showed worse glycemic control than those with a BMI of 21.0-23.0kg/m(2) in group C. Younger patients had worse glycemic control and shorter untreated durations in group C. A BMI 23.0kg/m(2) was an independent risk factor for glycated hemoglobin levels 8.4% in group C, even after correction for sex, age, untreated duration and symptoms. ConclusionsIn recent years, glycemic control has worsened in young, obese patients in urban Japan. Obesity is rapidly increasing in younger patients, and patients with a BMI 23.0kg/m(2) might be candidates for diabetes screening. This trial was registered with the University Medical Information Network Clinical Trials Registry (no. UMIN000005725).