Weight change and glycemic control after diagnosis of type 2 diabetes

J Gen Intern Med. 2008 Sep;23(9):1339-45. doi: 10.1007/s11606-008-0681-2. Epub 2008 Jun 28.

Abstract

Background: Limited community-based data describe weight change after diabetes diagnosis.

Objective: To evaluate weight change patterns and associations in the 1st year after diabetes mellitus type 2 diagnosis.

Design: Retrospective cohort study.

Participants: Patients aged 21-75 with diabetes mellitus type 2 diagnosed between 1 January 1997 and 31 December 2004, identified from electronic medical records in Kaiser Permanente Northwest, a health maintenance organization. Eligible patients met weight measurement criteria (a baseline and three additional weight measurements) and did not have a condition associated with unintentional weight change (n = 4,135).

Measurements: We estimated 12-month patient weight trajectories using growth curve analyses, grouped similar trajectories using cluster analysis, and compared characteristics among groups.

Results: The four weight trajectory groups were "higher stable weight" (n = 757; 18.3%), "lower stable weight" (n = 2,236; 54.1%), "weight gain" (n = 664; 16.0%), and "weight loss" (n = 478; 11.6%). After adjustments, members of the weight-loss group were more likely than those in the weight-gain group to be older, female, take fewer medications, have had nutritionist visits, and have a lower mean HbA(1c). Those in the weight-loss group were less likely to be in a race group at higher risk for obesity, have depression or dyslipidemia, or have taken >30 days of a sulfonylurea alone or with metformin.

Conclusions: A small-but-substantial group of patients had a mean weight trajectory that included a clinically significant weight loss. Weight-loss trajectories were strongly associated with better glycemic control when compared to weight gain. Patients with certain characteristics may need more support for weight loss.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Female
  • Glycated Hemoglobin
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Retrospective Studies
  • Weight Gain*
  • Weight Loss*

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents