Cargando…

Weight Change in Diabetes and Glycemic and Blood Pressure Control

OBJECTIVE—Weight loss in type 2 diabetes is undisputedly important, and data from community settings are limited. We evaluated weight change and resulting glycemic and blood pressure control in type 2 diabetic patients at an HMO. RESEARCH DESIGN AND METHODS—Using electronic medical records, this ret...

Descripción completa

Detalles Bibliográficos
Autores principales: Feldstein, Adrianne C., Nichols, Gregory A., Smith, David H., Stevens, Victor J., Bachman, Keith, Rosales, A. Gabriela, Perrin, Nancy
Formato: Texto
Lenguaje:English
Publicado: American Diabetes Association 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2551635/
https://www.ncbi.nlm.nih.gov/pubmed/18697899
http://dx.doi.org/10.2337/dc08-0426
_version_ 1782159450822410240
author Feldstein, Adrianne C.
Nichols, Gregory A.
Smith, David H.
Stevens, Victor J.
Bachman, Keith
Rosales, A. Gabriela
Perrin, Nancy
author_facet Feldstein, Adrianne C.
Nichols, Gregory A.
Smith, David H.
Stevens, Victor J.
Bachman, Keith
Rosales, A. Gabriela
Perrin, Nancy
author_sort Feldstein, Adrianne C.
collection PubMed
description OBJECTIVE—Weight loss in type 2 diabetes is undisputedly important, and data from community settings are limited. We evaluated weight change and resulting glycemic and blood pressure control in type 2 diabetic patients at an HMO. RESEARCH DESIGN AND METHODS—Using electronic medical records, this retrospective cohort study identified 2,574 patients aged 21–75 years who received a new diagnosis of type 2 diabetes between 1997 and 2002. We estimated 3-year weight trajectories using growth curve analyses, grouped similar trajectories into four categories using cluster analysis, compared category characteristics, and predicted year-4 above-goal A1C and blood pressure by group. RESULTS—The weight-trajectory groups were defined as higher stable weight (n = 418; 16.2%), lower stable weight (n = 1,542; 59.9%), weight gain (n = 300; 11.7%), and weight loss (n = 314; 12.2%). The latter had a mean weight loss of 10.7 kg (−9.8%; P < 0.001) by 18 months, with near-complete regain by 36 months. After adjusting for age, sex, baseline control, and related medication use, those with higher stable weight, lower stable weight, or weight-gain patterns were more likely than those who lost weight to have above-goal A1C (odds ratio [OR] 1.66 [95% CI 1.12–2.47], 1.52 [1.08–2.14], and 1.77 [1.15–2.72], respectively). Those with higher stable weight or weight-gain patterns were more likely than those who lost weight to have above-goal blood pressure (1.83 [1.31–2.57] and 1.47 [1.03–2.10], respectively). CONCLUSIONS—A weight-loss pattern after new diagnosis of type 2 diabetes predicted improved glycemic and blood pressure control despite weight regain. The initial period postdiagnosis may be a critical time to apply weight-loss treatments to improve risk factor control.
format Text
id pubmed-2551635
institution National Center for Biotechnology Information
language English
publishDate 2008
publisher American Diabetes Association
record_format MEDLINE/PubMed
spelling pubmed-25516352009-10-01 Weight Change in Diabetes and Glycemic and Blood Pressure Control Feldstein, Adrianne C. Nichols, Gregory A. Smith, David H. Stevens, Victor J. Bachman, Keith Rosales, A. Gabriela Perrin, Nancy Diabetes Care Clinical Care/Education/Nutrition/Psychosocial Research OBJECTIVE—Weight loss in type 2 diabetes is undisputedly important, and data from community settings are limited. We evaluated weight change and resulting glycemic and blood pressure control in type 2 diabetic patients at an HMO. RESEARCH DESIGN AND METHODS—Using electronic medical records, this retrospective cohort study identified 2,574 patients aged 21–75 years who received a new diagnosis of type 2 diabetes between 1997 and 2002. We estimated 3-year weight trajectories using growth curve analyses, grouped similar trajectories into four categories using cluster analysis, compared category characteristics, and predicted year-4 above-goal A1C and blood pressure by group. RESULTS—The weight-trajectory groups were defined as higher stable weight (n = 418; 16.2%), lower stable weight (n = 1,542; 59.9%), weight gain (n = 300; 11.7%), and weight loss (n = 314; 12.2%). The latter had a mean weight loss of 10.7 kg (−9.8%; P < 0.001) by 18 months, with near-complete regain by 36 months. After adjusting for age, sex, baseline control, and related medication use, those with higher stable weight, lower stable weight, or weight-gain patterns were more likely than those who lost weight to have above-goal A1C (odds ratio [OR] 1.66 [95% CI 1.12–2.47], 1.52 [1.08–2.14], and 1.77 [1.15–2.72], respectively). Those with higher stable weight or weight-gain patterns were more likely than those who lost weight to have above-goal blood pressure (1.83 [1.31–2.57] and 1.47 [1.03–2.10], respectively). CONCLUSIONS—A weight-loss pattern after new diagnosis of type 2 diabetes predicted improved glycemic and blood pressure control despite weight regain. The initial period postdiagnosis may be a critical time to apply weight-loss treatments to improve risk factor control. American Diabetes Association 2008-10 /pmc/articles/PMC2551635/ /pubmed/18697899 http://dx.doi.org/10.2337/dc08-0426 Text en Copyright © 2008, American Diabetes Association https://creativecommons.org/licenses/by-nc-nd/3.0/Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Clinical Care/Education/Nutrition/Psychosocial Research
Feldstein, Adrianne C.
Nichols, Gregory A.
Smith, David H.
Stevens, Victor J.
Bachman, Keith
Rosales, A. Gabriela
Perrin, Nancy
Weight Change in Diabetes and Glycemic and Blood Pressure Control
title Weight Change in Diabetes and Glycemic and Blood Pressure Control
title_full Weight Change in Diabetes and Glycemic and Blood Pressure Control
title_fullStr Weight Change in Diabetes and Glycemic and Blood Pressure Control
title_full_unstemmed Weight Change in Diabetes and Glycemic and Blood Pressure Control
title_short Weight Change in Diabetes and Glycemic and Blood Pressure Control
title_sort weight change in diabetes and glycemic and blood pressure control
topic Clinical Care/Education/Nutrition/Psychosocial Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2551635/
https://www.ncbi.nlm.nih.gov/pubmed/18697899
http://dx.doi.org/10.2337/dc08-0426
work_keys_str_mv AT feldsteinadriannec weightchangeindiabetesandglycemicandbloodpressurecontrol
AT nicholsgregorya weightchangeindiabetesandglycemicandbloodpressurecontrol
AT smithdavidh weightchangeindiabetesandglycemicandbloodpressurecontrol
AT stevensvictorj weightchangeindiabetesandglycemicandbloodpressurecontrol
AT bachmankeith weightchangeindiabetesandglycemicandbloodpressurecontrol
AT rosalesagabriela weightchangeindiabetesandglycemicandbloodpressurecontrol
AT perrinnancy weightchangeindiabetesandglycemicandbloodpressurecontrol