Weight change in diabetes and glycemic and blood pressure control

Diabetes Care. 2008 Oct;31(10):1960-5. doi: 10.2337/dc08-0426. Epub 2008 Jun 20.

Abstract

Objective: Weight loss in type 2 diabetes is undisputedly important, and data from community settings are limited. We evaluated weight change and resulting glycemic and blood pressure control in type 2 diabetic patients at an HMO.

Research design and methods: Using electronic medical records, this retrospective cohort study identified 2,574 patients aged 21-75 years who received a new diagnosis of type 2 diabetes between 1997 and 2002. We estimated 3-year weight trajectories using growth curve analyses, grouped similar trajectories into four categories using cluster analysis, compared category characteristics, and predicted year-4 above-goal A1C and blood pressure by group.

Results: The weight-trajectory groups were defined as higher stable weight (n = 418; 16.2%), lower stable weight (n = 1,542; 59.9%), weight gain (n = 300; 11.7%), and weight loss (n = 314; 12.2%). The latter had a mean weight loss of 10.7 kg (-9.8%; P < 0.001) by 18 months, with near-complete regain by 36 months. After adjusting for age, sex, baseline control, and related medication use, those with higher stable weight, lower stable weight, or weight-gain patterns were more likely than those who lost weight to have above-goal A1C (odds ratio [OR] 1.66 [95% CI 1.12-2.47], 1.52 [1.08-2.14], and 1.77 [1.15-2.72], respectively). Those with higher stable weight or weight-gain patterns were more likely than those who lost weight to have above-goal blood pressure (1.83 [1.31-2.57] and 1.47 [1.03-2.10], respectively).

Conclusions: A weight-loss pattern after new diagnosis of type 2 diabetes predicted improved glycemic and blood pressure control despite weight regain. The initial period postdiagnosis may be a critical time to apply weight-loss treatments to improve risk factor control.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / metabolism*
  • Blood Pressure / physiology*
  • Body Mass Index
  • Body Weight*
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetes Mellitus, Type 2 / prevention & control
  • Female
  • Glycated Hemoglobin / metabolism
  • Humans
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / epidemiology
  • Overweight / complications
  • Overweight / epidemiology
  • Registries
  • Retrospective Studies
  • Weight Loss*

Substances

  • Blood Glucose
  • Glycated Hemoglobin A