Background: Physical inactivity and excess adiposity are well-established contributors to poor glycemic control in type 2 diabetes mellitus (T2DM). Data on self-reported physical activity (SRPA) and adiposity patterns among T2DM patients with high mean HbA1c in urban South Indian private clinic settings remain limited.

Objectives: To determine SRPA levels, BMI-based general obesity, and visceral obesity (by bipolar bioelectrical impedance analysis), and to assess their association with glycemic status in T2DM patients with high mean HbA1c.

Methods: A cross-sectional study was conducted among 300 T2DM patients attending a private diabetes clinic in a South Indian city. SRPA was assessed using a WHO questionnaire-based tool. Adiposity was evaluated by BMI (general obesity) and bipolar bioelectrical impedance analysis (visceral obesity). Glycemic status was assessed by fasting blood glucose (FBG), postprandial blood glucose (PPBG), and HbA1c. Statistical analysis included descriptive statistics, chi-square test, Pearson's correlation, and binary logistic regression.

Results: The mean HbA1c was 9.4 ± 1.6%. Majority (68.3%) were physically inactive by SRPA criteria. General obesity (BMI ≥25 kg/m²) was present in 71.7% and elevated visceral fat (≥10 units) in 63.3% of participants. Physical inactivity, general obesity, and visceral obesity were each significantly associated with poor glycemic control (p<0.001). On logistic regression, physical inactivity (OR 2.84, 95% CI 1.74–4.63) and elevated visceral fat (OR 2.31, 95% CI 1.42–3.76) were independent predictors of high HbA1c.

Conclusion: Physical inactivity and adiposity — both general and visceral — are prevalent and independently associated with poor glycemic control in South Indian T2DM patients. Structured lifestyle interventions targeting these modifiable risk factors are urgently warranted.

Keywords: Type 2 diabetes mellitus, self-reported physical activity, adiposity, HbA1c, bioelectrical impedance analysis.

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Dr. S.J. Sanketh

Department of Gen Medicine, J.J.M. Collage and Research Centre, Davanagere, Karnataka, India