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Gaining Weight after Diabetes Diagnosis Increases Mortality

Posted: Sunday, November 04, 2012

Dr. Johan Bodegard and his associates reported in a poster at the annual meeting of the European Association for the Study of Diabetes (EASD), that from an analysis of 8,500 patients in primary care practices, "Weight gain in patients with newly diagnosed type 2 diabetes may be more hazardous than previously recognized," suggesting that steps should be taken to limit weight gain in this patient group.

605-Item1-1 The analysis showed that among 1,238 patients who gained at least one body mass index unit (1 kg/m²) during the first year following incident diagnosis with type 2 diabetes had a cardiovascular mortality rate 63% above that of 4,523 patients whose BMI didn't change, and they had an all-cause mortality 34% above the unchanged group, both statistically significant differences. The analysis was adjusted for baseline differences in age, sex, BMI, prior angina, education, marital status, and glucose-lowering drugs.

The researchers examined records from 8,486 people who were patients in 84 primary-care centers in Sweden during 1999-2008. Patients included in the analysis had newly diagnosed type 2 diabetes who had their BMI measured at the time of initial diagnosis and also 1 year later, and also had no newly diagnosed cardiovascular disease or cancer during the first year following their diabetes diagnosis.

During that first year, 14% of the patients gained at least 1 kg/m², 32% lost at least 1 kg/m², and 53% had no change (percentages total 99% because of rounding). At baseline, the patients' average age was 58 years, slightly more than half were men, and average BMI was 31 kg/m². About a third of the patients received at least one antidiabetes drug. During a median follow-up of 4.6 years, 197 patients died from cardiovascular disease and 423 patients died overall.

The patients who added at least 1 kg/m² during the first year of follow-up remained at an elevated BMI throughout the study. The weight gainers also had higher levels of hemoglobin A_1c and higher rates of treatment with insulin and sulfonylurea drugs during follow-up, compared with the patients who didn't change or those who lost weight. But all three subgroups showed similar patterns for blood pressure and cholesterol levels throughout follow-up.

From the results of the study, it was concluded that Increase in body mass index during the first year after new onset diabetes is associated with increased long term risk of death due to cardiovascular disease. The study also suggests that the level of BMI increase is associated with an elevated risk of dying from cardiovascular disease and every effort should be made to minimize increase in BMI in diabetes patients.

Source: http://www.diabetesincontrol.com/articles/diabetes-news/13764-gaining-weight-after-diabetes-diagnosis-increases-mortality, Presented as an abstract at the EASD Oct. 2012.