Weight Changes After Diabetes Diagnosis and Risk of CVD, Mortality

Takeaway

• Both weight loss and weight gain after type 2 diabetes (T2D) diagnosis by screening were associated with increased risk of all-cause mortality, but not cardiovascular disease (CVD) events, particularly in individuals without obesity.

Why this matters

• Findings suggest that weight loss may differently affect people with T2D dependent on body mass index (BMI).
• Personalisation of weight loss advice and support may be warranted.

Study design

• This was an observational analysis of the ADDITION-Europe trial including 2730 adults with screen-detected T2D from the UK, Denmark and the Netherlands.
• Associations between changes in weight 5 years following T2D diagnosis and incident CVD events (n=229) and (n=225) mortality up to 10 years after diagnosis were evaluated.
• Funding: Medical Research Council.

Key results

• Weight loss in the year after T2D diagnosis (weight loss ≥5% with regain: HR, 2.72; 95% CI, 1.17-6.30) and weight gain >2% (HR, 3.18; 95% CI, 1.30-7.82) correlated with a greater risk of all-cause mortality vs maintained weight.
• Weight loss ≥5% that was maintained was associated with all-cause mortality (HR, 2.47; 95% CI, 0.99-6.21).
• Weight loss ≥10% in the 5 years following T2D diagnosis was associated with a higher risk of all-cause mortality (HR, 2.04; 95% CI, 1.17-3.55).
• This association was strong in those with BMI <30 kg/m² (HR, 4.62; 95% CI, 1.87-11.42).
• Associations of 1- and 5-year weight changes with CVD incidence were inconclusive.

Limitations

• Study could not distinguish between intentional and unintentional weight loss.

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.