Large weight loss and weight swings may predict increased mortality and CVD risk in type 2 diabetes

China: A study published in Cardiovascular Diabetology suggests that large weight loss and weight swings may be indicators of an elevated risk of cardiovascular events and mortality in type 2 diabetes (T2DM) patients.

Current recommendations strongly advocate weight control for overweight or obese people with T2DM. However, the prognostic influence of weight reduction without behavioral intervention on mortality and cardiovascular (CV) outcomes in diabetes individuals remains debatable. As a result, Shan Huang and colleagues undertook this analysis with the goal of synthesizing the available information on the effect of weight reduction accomplished without behavioral intervention on all-cause mortality and major CV events in T2DM patients.

The PubMed, Embase, and Cochrane Library databases were searched for studies that studied the relationship of weight reduction or weight variability with mortality and CV outcomes for this study. The results of studies that assessed weight loss as a percentage of baseline weight reduction and classified it as > 10% and 5–10%, or studies that computed weight variability, were pooled using a random-effects model. The Newcastle–Ottawa Scale was used to assess the study's quality.

The key findings of this study were as follows:

1. The systematic review contained thirty eligible papers, and 13 of them were included in the meta-analysis.

2. Weight loss of more than 10% was linked to an increased risk of all-cause mortality, a composite of major CV events, and CV death in T2DM patients.

3. Moderate weight reduction had no correlation with all-cause mortality or CV outcomes. Weight variation was linked to an increased risk of all-cause death.

In conclusion, large weight loss and weight swings may be indicators of an elevated risk of mortality and CV events in T2DM patients. Weight change as a global indicator for physical state may indicate the overall influence of many pathophysiologic processes, suggesting illness development and deterioration of health status. Weight loss should not be the exclusive goal of T2DM treatment. Maintaining a healthy lifestyle and a constant weight may be more essential.

Reference:

Huang, S., Shi, K., Ren, Y., Wang, J., Yan, W.-F., Qian, W.-L., Yang, Z.-G., & Li, Y. (2022). Association of magnitude of weight loss and weight variability with mortality and major cardiovascular events among individuals with type 2 diabetes mellitus: a systematic review and meta-analysis. In Cardiovascular Diabetology (Vol. 21, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12933-022-01503-x