- Unintentional weight loss was linked to increased risk for cardiovascular outcomes and mortality in adults with type 2 diabetes (T2D).
Why this matters
- Unless patients specifically report lifestyle changes, even modest weight loss may indicate declining health, meriting further investigation.
- Data from 10,081 participants in the ADVANCE trial (591 major macrovascular events) and follow-up ADVANCE-ON (978 events).
- Funding: Servier; National Health and Medical Research Council of Australia.
- At 2 years:
- 56.7% of participants were weight-stable,
- 4.3% and 18.4% had respective weight losses of >10% and 4%-10%, and
- 15.4% and 5.3% had respective weight gains of 4%-10% and >10%.
- After adjustments, >10% weight loss was strongly associated with (HRs; 95% CIs):
- Major macrovascular events: 1.75 (1.26-2.44);
- Cardiovascular mortality: 2.76 (1.87-4.09); and
- All-cause mortality: 2.79 (2.10-3.71).
- Moderate (4%-10%) weight loss was also associated with greater all-cause mortality (HR, 1.43; 95% CI, 1.16-1.76) but not the other endpoints.
- Large weight gain (>10%) was marginally associated with major macrovascular events (HR, 1.40; 95% CI, 1.00-1.95).
- No direct information regarding intentional or unintentional weight change.
- BP and HbA1c interventions could mask weight-loss benefits.
- No information on diet.