Does weight loss following diabetes diagnosis lower risk for cardiovascular disease?

  • Strelitz J & al.
  • Diabetologia
  • 7 May 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In patients with type 2 diabetes (T2D), loss of ≥5% body weight during the year following diagnosis is associated with a lower risk for cardiovascular disease (CVD) events at 10 years, but not mortality, compared with maintaining weight.

Why this matters

  • Findings support a greater focus towards achieving weight loss in people with newly diagnosed diabetes.

Study design

  • A prospective cohort study of 725 adults with T2D (99 with CVD events and 95 with all-cause death) recruited in the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION)-Cambridge trial.
  • Main outcomes: CVD events and all cause-mortality.
  • Funding: Wellcome Trust and others.

Key results

  • Losing ≥5% body weight vs maintaining weight in the year following diabetes diagnosis was associated with a lower risk for 10-year CVD events (HR, 0.52; 95% CI, 0.32-0.86), but not with all-cause mortality (HR, 1.12; 95% CI, 0.52-2.37).
  • The associations between weight gain and 10-year CVD events (HR, 0.41; 95% CI, 0.15-1.11) and mortality (HR, 1.63; 95% CI, 0.83-3.19) were less apparent.
  • At 1 year, losing ≥5% body weight vs maintaining weight was associated with improvement in:
    • HBA1c level (β coefficient, −4.91 [95% CI, −6.54 to −3.27] mmoL/moL);
    • diastolic blood pressure (β, −2.37 [95% CI, −4.03 to −0.71] mmHg);
    • triacylglycerols level (β, −0.21 [95% CI, −0.33 to −0.10] mmoL/L).

Limitations

  • Results limit generalisability.
  • Findings not applicable to normal weight and underweight people.