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Effect of weight change on remission in people with newly diagnosed type 2 diabetes

Weight loss in the early stage of type 2 diabetes has an important effect on the prognosis.

In this study, the authors used the Korean National Health Insurance Service Database to investigate weight change in people with newly diagnosed type 2 diabetes and its effect on remission rates. Data on 114 874 people diagnosed between 2009 and 2012 were analysed. Of these, 20.5% lost ≥5% of body weight in the first 2 years from diagnosis, 65.7% had no significant change and 13.8% gained weight by ≥5%.

Older age, female sex, regular exercise and a higher BMI were associated with weight loss, while current smoking, alcohol intake, insulin use and use of multiple glucose-lowering therapies were associated with weight gain.

Over the 5 years of follow-up, 2429 individuals (2.1%) achieved remission, defined as fasting blood glucose levels below 7.0 mmol/L on two or more consecutive health checks (generally held 2 years apart). In univariate analysis, remission was significantly more likely in those who achieved weight loss (odds ratio [OR] 2.63) and significantly less likely in those who gained weight (OR 0.73). After adjustment for confounding factors such as baseline body weight and treatment modality, weight loss remained significantly associated with remission (OR 2.56), whilst the association with weight gain was no longer significant compared with weight maintenance.

People who achieved remission tended to have fewer comorbidities and lower fasting glucose levels at baseline, as well as healthier lifestyles in terms of smoking, alcohol and physical activity. The effect of weight loss on remission was significantly greater in people aged under 65 years, males and those with a BMI over 25 kg/m2.

The authors note that weight change was only analysed in the first 2 years and that it is unknown how weight trajectories may have changed thereafter. The fact that diabetes remission occurred irrespective of subsequent weight gain suggests that weight loss in the early stage of type 2 diabetes has an important effect on the prognosis, and thus the authors recommend focusing on weight loss in people with newly diagnosed type 2 diabetes, particularly in younger individuals and whose with obesity.

Click here to read the study in full.

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