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 HbA1c. 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.
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Acknowledgments
We would like to thank several individuals who assisted with the design and interpretation of the study and who were critical organizational advocates for the project: Victor Stevens, PhD; Keith Bachman, MD; Harold Glauber, MD; Michael Herson, MD. We would also like to thank Martha Swain for editorial assistance and Debra Burch for administrative support.
Conflict of Interest
Dr. Feldstein has received research grants from Merck and Co., Inc., Sanofi-Aventis and Amgen. Dr. Nichols has received research grant support from GlaxoSmithKline Inc., Bristol-Myers Squibb, Sanofi-Aventis, Amgen, Merck & Co., Inc., Pfizer Inc., and Eli Lilly & Co. Dr. Smith has received research grant support from Sanofi-Aventis, Abbot, Amgen, and Genzyme.
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This study was supported by grant no. R21 DK073546–02 (Weight in Secondary Prevention) from the National Institute of Diabetes and Digestive and Kidney Diseases
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Feldstein, A.C., Nichols, G.A., Smith, D.H. et al. Weight Change and Glycemic Control After Diagnosis of Type 2 Diabetes. J GEN INTERN MED 23, 1339–1345 (2008). https://doi.org/10.1007/s11606-008-0681-2
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DOI: https://doi.org/10.1007/s11606-008-0681-2