BERLIN – Adults who gained weight during the first year following their initial diagnosis with type 2 diabetes had a significantly increased risk for cardiovascular-disease death and for all-cause death, in an analysis of nearly 8,500 patients in Swedish primary care practices.
"Weight gain in patients with newly diagnosed type 2 diabetes may be more hazardous than previously recognized," Dr. Johan Bodegard and his associates reported in a poster at the annual meeting of the European Association for the Study of Diabetes. Steps should be taken to limit weight gain in this patient group, said Dr. Bodegard, a researcher with AstraZeneca in Södertälje, Sweden, and his associates.
The analysis showed that among 1,238 patients who gained at least one body mass index unit (1 kg/m2) during the first year following incident diagnosis with type 2 diabetes had a cardiovascular mortality rate 63% above that of 4,523 patients whose BMI didn’t change, and they had an all-cause mortality 34% above the unchanged group, both statistically significant differences. The analysis was adjusted for baseline differences in age, sex, BMI, prior angina, education, marital status, and glucose-lowering drugs.
The researchers examined records from 8,486 people who were patients in 84 primary-care centers in Sweden during 1999-2008. Patients included in the analysis had newly diagnosed type 2 diabetes who had their BMI measured at the time of initial diagnosis and also 1 year later, and also had no newly diagnosed cardiovascular disease or cancer during the first year following their diabetes diagnosis.
During that first year, 14% of the patients gained at least 1 kg/m2, 32% lost at least 1 kg/m2, and 53% had no change (percentages total 99% because of rounding). At baseline, the patients’ average age was 58 years, slightly more than half were men, and average BMI was 31 kg/m2. About a third of the patients received at least one antidiabetes drug. During a median follow-up of 4.6 years, 197 patients died from cardiovascular disease and 423 patients died overall.
The patients who added at least 1 kg/m2 during the first year of follow-up remained at an elevated BMI throughout the study. The weight gainers also had higher levels of hemoglobin A1c and higher rates of treatment with insulin and sulfonylurea drugs during follow-up, compared with the patients who didn’t change or those who lost weight. But all three subgroups showed similar patterns for blood pressure and cholesterol levels throughout follow-up.
The study was sponsored by AstraZeneca. Dr. Bodegard is an employee of AstraZeneca.