Trajectories of BMI before and after diagnosis of type 2 diabetes in a real-world population
Authors' conclusion
Average weight increases before diagnosis and decreases after diagnosis; however, there were significant differences across the population in terms of weight changes. Younger individuals gained weight pre-diagnosis, but, in older individuals, type 2 diabetes is less associated with weight gain, consistent with other drivers for diabetes aetiology in older adults. We have identified a substantial group of individuals who have a rapid deterioration in glycaemic control, together with weight loss, around the time of diagnosis, and who subsequently stabilise, suggesting that a high HbA1c at diagnosis is not inevitably associated with a poor outcome and may be driven by reversible glucose toxicity.
Study context
- Population
- Individuals with T2D in the Scottish Care Information Diabetes Collaboration database
- Participants
- 2,736 individuals
- Outcome
- BMI trajectories before (3 years to 6 months before) and after (1 to 5 years after) diabetes diagnosis
Methodological detailselectronic medical records, real-world
- Electronic medical records
- Real-world
Main finding
As reported in the abstract
Gained weight overall before diagnosis
1944
71%
Gained >0.5 kg/m² per year before diagnosis
875
32%
Lost weight after diagnosis
1722
63%
Observational data: associations, not effects.
Further findings
Factors associated with pre-diagnosis weight gain
- Younger age and greater social deprivation associated with increased weight gain before diagnosis
Factors associated with post-diagnosis weight loss
- Pre-diagnosis weight change unrelated to post-diagnosis weight change
- Post-diagnosis weight loss associated with older age, female sex, higher BMI, higher HbA1c and peri-diagnosis weight gain
Peri-diagnostic subgroup (6 months before to 12 months after diagnosis): high HbA1c at diagnosis, rapid weight loss, most aggressively treated at 1 year · 5 years
- Individuals in subgroup
- 986 (36%)
- Subgroup had the best glycaemic control at 5 years
Original publication
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