Do newly diagnosed type 2 diabetics succeed in weight management?
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A register-based study from Finland identified three distinct BMI trajectory groups among patients with newly diagnosed type 2 diabetes.
The study was carried out by researchers at the University of Eastern Finland, and was published in the journal Clinical Epidemiology.
Most type 2 diabetes (T2D) patients live with obesity, and weight loss is one of the therapeutic objectives in T2D management. Clinical trials have demonstrated that modest weight loss, i.e, 5‒10%, in T2D patients with high BMI improves the risk factors of diabetes complications, such as hyperglycaemia, hyperlipidaemia, and hypertension. Complications of type 2 diabetes (T2D) can be classified into microvascular (retinopathy, neuropathy, nephropathy) and macrovascular (cardiovascular disease, cerebrovascular disease, peripheral vascular disease) categories. Observational studies exploring the association between BMI and these complications have yielded mixed results, with some showing positive, inverse, or no associations.
In this cohort study, electronic health records from public primary and specialized healthcare services were utilized and included a total of 889 adults with newly diagnosed T2D between 2011 or 2012 (mean age at baseline 62.0 years). Individual BMI trajectories from the T2D diagnosis until 2014 were estimated. Data was collected on patients’ birth year, sex, measurements of BMI, fasting plasma glucose (FPG), glycated haemoglobin (HbA1c) and low-density lipoprotein (LDL), diagnosis codes and dates for T2D and complications, as well as the date of death.
The results revealed that in a four-year follow-up, most patients followed a stable trajectory without much weight change. Only 10% of patients lost weight, whereas 3% gained weight. Mean BMI exceeded the threshold of obesity in all groups at baseline. Patients belonging to each trajectory group were followed up for another eight years for diabetes complications. During the follow-up, 13% of all patients developed microvascular complications, 21% developed macrovascular complications and 20% of patients deceased. The risk of microvascular complications was 2.9 times higher and the risk of macrovascular complications 2.5 times higher among patients with an increasing BMI compared to those with a stable BMI.
“These results underscore the significance of continuous BMI monitoring and weight management in patients with type 2 diabetes. Tailored treatments and support with lifestyle changes are crucial for efficiently preventing weight gain and reducing the risk of diabetes complications,” said Doctoral Researcher Zhiting Wang of the University of Eastern Finland.
Reference: Zhiting Wang, Piia Lavikainen, Katja Wikström, Tiina Laatikainen; Trajectories of Body Mass Index and Risk for Diabetes Complications and All-Cause Mortality in Finnish Type 2 Diabetes Patients; Journal: Clinical Epidemiology; https://doi.org/10.2147/CLEP.S450455
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