Weight change and glycemic control after diagnosis of type 2 diabetes.
BACKGROUND
Limited community-based data describe weight change after diabetes diagnosis.


OBJECTIVE
To evaluate weight change patterns and associations in the 1st year after diabetes mellitus type 2 diagnosis.


METHODS
Retrospective cohort study.


METHODS
Patients aged 21-75 with diabetes mellitus type 2 diagnosed between 1 January 1997 and 31 December 2004, identified from electronic medical records in Kaiser Permanente Northwest, a health maintenance organization. Eligible patients met weight measurement criteria (a baseline and three additional weight measurements) and did not have a condition associated with unintentional weight change (n = 4,135).


METHODS
We estimated 12-month patient weight trajectories using growth curve analyses, grouped similar trajectories using cluster analysis, and compared characteristics among groups.


RESULTS
The four weight trajectory groups were "higher stable weight" (n = 757; 18.3%), "lower stable weight" (n = 2,236; 54.1%), "weight gain" (n = 664; 16.0%), and "weight loss" (n = 478; 11.6%). After adjustments, members of the weight-loss group were more likely than those in the weight-gain group to be older, female, take fewer medications, have had nutritionist visits, and have a lower mean HbA(1c). Those in the weight-loss group were less likely to be in a race group at higher risk for obesity, have depression or dyslipidemia, or have taken >30 days of a sulfonylurea alone or with metformin.


CONCLUSIONS
A small-but-substantial group of patients had a mean weight trajectory that included a clinically significant weight loss. Weight-loss trajectories were strongly associated with better glycemic control when compared to weight gain. Patients with certain characteristics may need more support for weight loss.
Feldstein
Adrianne C
AC
Center for Health Research, Kaiser Permanente Northwest, Portland, OR 97227, USA. Adrianne.C.Feldstein@kpchr.org
Nichols
Gregory A
GA
Smith
David H
DH
Rosales
A Gabriela
AG
Perrin
Nancy
N
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015430:Weight Gain; D015431:Weight Loss
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents