Objective: Obesity and prediabetes are widespread in the U.S., with an estimated 42% of adults living with obesity and 35% living with prediabetes. This research examines the prevalence of comorbidities among people with obesity with or without prediabetes over a 5-year period.

Methods: This observational study uses Optum® Market Clarity deidentified data from 2007-2020. For adults with obesity and prediabetes, the index date was defined as the first date where the person was identified with both obesity (BMI ≥ 30 kg/m2) and prediabetes (5.7% ≤ A1c < 6.5%) while for adults with obesity without prediabetes (obesity only) , the index date was defined as the first date with BMI ≥ 30 kg/m2. All patients were required to be continuously insured from 1 year prior through 5 years post index date. For both cohorts, patients were excluded if there was any prior evidence of diabetes and in the obesity only cohort individuals were excluded if identified with prediabetes in the pre-period. Prevalence rates and 95% CIs were calculated for comorbidities for each 365-day period post index date and over the entire 5-year post-period.

Results: There were 22,423 individuals with obesity and prediabetes (mean age = 58.5 years; 42.2% male) and 902,975 individuals with obesity only (mean age = 51.7 years; 46.1% male) . The mortality rate after 5 years was 16.7% for adults with obesity and prediabetes and 9.9% for adults with obesity only (p<0.05) . Five years post index date, the prevalence of T2D was 28.8% for people with obesity and prediabetes and 11.9% for people with obesity only (p<0.05) . Prevalence rates for heart failure (4.3% v 2.2%) , atherosclerotic cardiovascular disease (16.2% v 6.9%) , and obstructive sleep apnea (2.2% v 1.0%) were significantly higher for adults with obesity and prediabetes compared to adults with obesity without prediabetes (all p<0.05) .

Conclusion: Findings indicate that the presence of prediabetes contributes to the development of additional morbidity and mortality in adults with obesity over time.

Disclosure

J.Ford: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. M.J.Lage: Consultant; Eli Lilly and Company. K.Boye: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. J.P.Bae: None. K.A.Terrell: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. M.C.Bunck: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company.

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