# Association between body mass index and diabetes mellitus control classification among patients with type 2 diabetes mellitus: Evidence from the National Diabetes Registry of Muar District Health Office, Malaysia, from January 2021 to July 2023

## TL;DR

This study found a link between body mass index and diabetes control in type 2 diabetes patients in Malaysia, highlighting the need for better medication management and healthcare support.

## Contribution

The study provides new evidence on the association between BMI and diabetes control in a specific Malaysian population using national registry data.

## Key findings

- Higher BMI was associated with poorer diabetes control after adjusting for confounding factors.
- Medications like glucose-lowering drugs, ticlopidine, and statins were linked to diabetes control.
- The study population was predominantly older Malay women with varied levels of BMI control.

## Abstract

Type 2 diabetes mellitus (T2DM) is one of the most prevalent non-communicable diseases globally. This study aimed to determine the association between body mass index (BMI) and diabetes mellitus (DM) control among patients with T2DM.

A retrospective study was conducted from October 2023 to June 2024 using secondary data from the National Diabetes Registry (NDR) of Muar District Health Office, Johor. Patients with T2DM registered in the NDR and audited from 2021 to July 2023 were included. The association between BMI and DM control was analysed using hierarchical multinomial logistic regression.

A total of 1955 patients were included in the study. The prevalence of good, intermediate and poor BMI control was 38.8% (95% Confident Interval (CI)=36.7, 41.0), 22.2% (95% CI=20.3, 24.0) and 39.0% (95% CI=36.7, 41.2), respectively. Most patients were older Malay women. There was an association between BMI and DM control unadjusted (P<0.001) and adjusted for several confounding factors using seven models (P=0.003-0.034). The R2 value also improved from 0.008 to 0.293. Conclusion: Among patients with T2DM, a higher BMI, the creatinine level and medications such as glucose-lowering drugs, ticlopidine, acetylsalicylic acid and statins are associated with DM control. However, as the study design does not allow for the assessment of causality or progression over time, the findings should be interpreted as descriptive associations rather than as evidence of cause-and-effect relationships. Focus on medication compliance, healthcare providers’ role during medication consultation and stakeholders’ role in maintaining drug supplementation is needed.