Association Between Body Mass Index and Glycemic Control Among Adults Over 40 Years in Sialkot: A Cross-Sectional Correlational Study

Abstract

Background: Obesity and Type 2 Diabetes Mellitus (T2DM) are rapidly increasing in prevalence across South Asia, driven by urbanization and sedentary lifestyles. Excess adiposity contributes to insulin resistance and impaired glucose metabolism, leading to poor glycemic control reflected by elevated glycated hemoglobin (HbA1c). Despite global evidence, regional data from mid-sized Pakistani cities such as Sialkot remain limited. Objective: To evaluate the association between body mass index (BMI) and HbA1c among adults aged over 40 years in Sialkot, assessing whether increased BMI correlates with poorer glycemic regulation. Methods: A descriptive cross-sectional study was conducted among 200 adults (≥40 years) recruited from outpatient and community settings in Sialkot. Anthropometric measurements were recorded, BMI categorized using South Asian cut-offs, and fasting blood samples analyzed for HbA1c using high-performance liquid chromatography. Data were analyzed using SPSS v16.0 with Pearson correlation and independent t-tests at p<0.05 significance. Results: Mean BMI and HbA1c were 26.4±3.9 kg/m² and 6.8±1.2%, respectively. A strong positive correlation was observed between BMI and HbA1c (r=0.63, p<0.001). Obese participants had significantly higher HbA1c (7.5±1.0%) than non-obese individuals (6.1±0.8%). Conclusion: Increasing BMI is significantly associated with worsening glycemic control among adults over 40 years in Sialkot. BMI-based screening and early weight management are essential for diabetes prevention