Weight change in diabetes and glycemic and blood pressure control

Adrianne C. Feldstein, Keith Bachman, Gregory A. Nichols, A. Gabriela Rosales, David H. Smith, Nancy Perrin, Victor Stevens

Research output: Contribution to journalArticle

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 2,5 74 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 postdi-agnosis may be a critical time to apply weight-loss treatments to improve risk factor control.

Original languageEnglish (US)
Pages (from-to)1960-1965
Number of pages6
JournalDiabetes care
Volume31
Issue number10
DOIs
StatePublished - Oct 1 2008

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ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Feldstein, A. C., Bachman, K., Nichols, G. A., Rosales, A. G., Smith, D. H., Perrin, N., & Stevens, V. (2008). Weight change in diabetes and glycemic and blood pressure control. Diabetes care, 31(10), 1960-1965. https://doi.org/10.2337/dc08-0426