Weight change and glycemic control after diagnosis of type 2 diabetes

Adrianne C. Feldstein, Gregory A. Nichols, David H. Smith, A. Gabriela Rosales, Nancy Perrin

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)1339-1345
Number of pages7
JournalJournal of general internal medicine
Volume23
Issue number9
DOIs
StatePublished - Sep 2008
Externally publishedYes

Keywords

  • Diabetes
  • Glycemic control
  • Mellitus type 2
  • Weight change
  • Weight gain
  • Weight loss

ASJC Scopus subject areas

  • Internal Medicine

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