Characterization of the Distribution of Body Mass Index in People with Type 2 Diabetes in the Portuguese Population

Introduction: Type 2 diabetes (T2D) is a global health concern, closely linked to the obesity epidemic. In Portugal, the high prevalence of T2D, alongside important rates of overweight and obesity, highlights the need for targeted interventions. Methods: This multicentre, cross-sectional observational study aimed to characterize the Portuguese T2D population based on body mass index (BMI) and waist circumference (WC), while examining associated sociodemographic, clinical, and therapeutic factors. Adult patients with self-reported T2D were recruited from community pharmacies in June 2024. Data on anthropometric characteristics, clinical history, lifestyle, and antidiabetic medication were collected via questionnaires and pharmacy records. Results: A total of 1,132 participants were included (mean age 68.3 years [SD 10.8]; 51.0% female), 41.3% were overweight, 37.7% presented obesity (26.2% class I, 8.8% class II, 2.7% class III), and 21.0% had a BMI <25 kg/m2. Higher BMI correlated with younger age, female gender, unemployment, increased WC, and higher rates of comorbidities like hypertension, sleep apnoea, and chronic venous insufficiency of the lower limbs. Overall, 98.2% of participants were treated with non-insulin glucose-lowering agents, most commonly fixed-dose combinations of oral therapies (44.0%). Conclusion: Our findings highlight a high prevalence of overweight/obesity among individuals with T2D in Portugal. This finding emphasizes the need to optimize clinical follow-up and implementing more effective interventions for the prevention and management of obesity among individuals with T2D. Routine BMI and WC assessments are vital, and integrated, for individualized T2D management that should address both glycaemic control and obesity-related risks to improve quality of life and prevent premature morbidity and mortality.