OBJECTIVES: Hypertension and obesity are associated with long-term complications of type 2 diabetes mellitus (T2DM). A systematic literature review assessed the comorbidities’ prevalence in adults with T2DM.
METHODS: Electronic databases (PubMed, Embase, and Cochrane Library) were searched for articles published in English between 2001 and 2012 and related to T2DM plus hypertension and/or obesity. Bibliographies of included studies were also examined. Data were analyzed by continental regions (Africa, Asia, Europe, North America, Oceania, and South America).
RESULTS: We reviewed 2,688 abstracts and identified 92 relevant observational studies. Hypertension was defined by varying blood pressure cutpoints (e.g., 140/90, 130/85, or 130/80 mmHg) or sometimes not clearly defined. The prevalence rates for hypertension were: Africa, 38.5%-80%; Asia, 13.6%-85.8%; Europe, 29.3%-95%; North America, 52%-70.9%; Oceania, 79%-85%; South America, 50%-90.0%; and multiregional (Europe and Africa), 75.8%. Cutpoints for defining obesity by body mass index (BMI) or waist circumference (WC) also varied among the studies. The prevalence rates of obesity among adults with T2DM, were: Africa, 11.9%-54.6%; Asia, 20.1%-83.45%; Europe, 22.1%-96.9%; North America, 38%-62.4%; Oceania, 46%-51%; South America, 30.5%-80.6%. In Europe, the combined prevalence of obesity defined by BMI or waist-to-hip ratio was 50.9%-98.6%. Limited data suggest common comorbidity of both hypertension and obesity in adults with T2DM.
CONCLUSIONS: Across the globe, hypertension and obesity, separately or together, are common comorbidities in adults with T2DM. Accurately quantifying their prevalence in regional populations will help prioritize health care efforts for managing these comorbidities, with a goal of reducing their long-term health and cost consequences.
