Weight Gain Was Associated With Worsening Glycemia and Cardiovascular and Kidney Outcomes in Patients With Type 2 Diabetes Independent of Diabetes Medication in the GRADE Randomized Controlled Trial
Authors' conclusion
Liraglutide and sitagliptin were associated with initial weight loss and glargine and glimepiride with slight weight gain, followed by weight loss in metformin-treated T2D. Weight gain was associated with worsening glycemia and increased risk of cardiovascular and kidney outcomes largely independent of treatment.
Study context
- Population
- Participants with T2D on metformin; age 57 ± 10 years, 44% non-White, HbA1c 7.5% ± 0.5%, BMI 34.3 ± 6.8 kg/m²
- Participants
- 4,980 participants
- Comparison
- Insulin glargine vs glimepiride vs liraglutide vs sitagliptin added to metformin; weight change and its association with outcomes
- Primary endpoint
- Weight change and HR per kg of weight change for HbA1c >7.5%, CVD, kidney disease, neuropathy and diabetes treatment satisfaction
- Follow-up
- Over 5 years
Primary result
As reported in the abstract
Liraglutide
−3.5
mean · 95% CI −3.8,–3.2 · kg
Sitagliptin
−1.07
mean · 95% CI −1.4,–0.78 · kg
Glargine
0.45
mean · 95% CI 0.16–0.74 · kg
Glimepiride
0.89
mean · 95% CI 0.60–1.2 · kg
P < 0.0001
Further findings
| Outcome | HR | |
|---|---|---|
| Weight gain within first 6 months and subsequent CVDPer kg of weight change | 1.03 (95% CI 1.005–1.06) | |
| Weight gain at 1 year and HbA1c >7.5%Per kg of weight change | 1.05 (CI 1.04–1.07) | |
| Weight gain at 1 year and kidney diseasePer kg of weight change | 1.03 (CI 1.01–1.06) | |
| 0.512Hazard ratio (log scale) |
Weight gain within first 6 months and subsequent cardiovascular disease (CVD)
- Weight gain within first 6 months associated with increased risk of HbA1c >7.5%, with modest differences by treatment
New-onset neuropathy
- Baseline weight, but not weight gain, was associated with new-onset neuropathy
Diabetes treatment satisfaction
- Weight gain associated with lower diabetes treatment satisfaction
Original publication
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