Influence of Overweight and Obesity on Disease Progression, Healthcare Utilization and Costs Among People With Prediabetes: A Cohort Study in China
Author(s)
Chunlu Yu, PhD student, Luying Zhang, PhD, Wen Chen, PhD.
Fudan University, Shanghai, China.
Fudan University, Shanghai, China.
OBJECTIVES: To investigate the influence of overweight and obesity on disease progression, healthcare utilization and costs among people with prediabetes in China.
METHODS: Using data from a population cohort and biobank in Shanghai, China, we included 4904 individuals diagnosed with prediabetes at baseline in 2016 and followed up in 2019. Residents were categorized by baseline body mass index (BMI) into underweight (<18.5kg/m²), normal weight (18.5~24kg/m²), overweight (24~28kg/m²), and obese groups (≥28kg/m²). Their healthcare utilization and costs from 2014 to 2019 were extracted from electronic health records. Adjusting for baseline characteristics and health status, we used Logistic and Poisson regressions to assess the association between BMI categories and progression to type-2 diabetes (T2D) and new diabetes-associated comorbidities. Negative binomial regression and two-part models were employed to evaluate the influence of BMI categories on diabetes-related healthcare utilization and costs incurred in 2019.
RESULTS: The sample’s average age was 58.86 years, with 40.70% at normal weight, 42.92% overweight, and 14.54% obese. Over a median follow-up of 2.98 years, 10.40% progressed to T2D, and 43.88% occurred new diabetes-associated comorbidities. Compared to normal-weight, overweight and obese individuals exhibited 51% and 149% higher risks of T2D progression, and occurred 21% and 22% more new comorbidities. Annual outpatient visits increased by 34% for overweight and 47% for obese, with visits to community health centers (CHCs) rising by 34% and 56%, respectively. No significant differences were observed in annual inpatient visits or length of hospital stay. Obese individuals incurred 12% higher annual total and outpatient costs, with a 20% increase in costs at CHCs. Overweight people showed increased costs only at CHCs. BMI did not significantly affect inpatient costs.
CONCLUSIONS: Weight management for prediabetes should be of greater concern, given that overweight and obesity significantly increases the risk of disease progression, outpatient healthcare utilization and costs.
METHODS: Using data from a population cohort and biobank in Shanghai, China, we included 4904 individuals diagnosed with prediabetes at baseline in 2016 and followed up in 2019. Residents were categorized by baseline body mass index (BMI) into underweight (<18.5kg/m²), normal weight (18.5~24kg/m²), overweight (24~28kg/m²), and obese groups (≥28kg/m²). Their healthcare utilization and costs from 2014 to 2019 were extracted from electronic health records. Adjusting for baseline characteristics and health status, we used Logistic and Poisson regressions to assess the association between BMI categories and progression to type-2 diabetes (T2D) and new diabetes-associated comorbidities. Negative binomial regression and two-part models were employed to evaluate the influence of BMI categories on diabetes-related healthcare utilization and costs incurred in 2019.
RESULTS: The sample’s average age was 58.86 years, with 40.70% at normal weight, 42.92% overweight, and 14.54% obese. Over a median follow-up of 2.98 years, 10.40% progressed to T2D, and 43.88% occurred new diabetes-associated comorbidities. Compared to normal-weight, overweight and obese individuals exhibited 51% and 149% higher risks of T2D progression, and occurred 21% and 22% more new comorbidities. Annual outpatient visits increased by 34% for overweight and 47% for obese, with visits to community health centers (CHCs) rising by 34% and 56%, respectively. No significant differences were observed in annual inpatient visits or length of hospital stay. Obese individuals incurred 12% higher annual total and outpatient costs, with a 20% increase in costs at CHCs. Overweight people showed increased costs only at CHCs. BMI did not significantly affect inpatient costs.
CONCLUSIONS: Weight management for prediabetes should be of greater concern, given that overweight and obesity significantly increases the risk of disease progression, outpatient healthcare utilization and costs.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH87
Topic
Epidemiology & Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)