title: Impact of body weight on antidiabetic treatment and predictors of weight control under real-world conditions: a 2-year follow-up of DiaRegis cohort.
abstract: OBJECTIVE
  Treatment strategies for obese patients with type 2 diabetes mellitus aim to increase physical activity, reduce body weight, and improve glucose control using weight-beneficial antidiabetic drugs. The objective of this study was to determine whether these strategies are implemented, and to identify factors predictive of glucose control and body weight management in a large, real-world patient population.
  
  
  METHODS
  The prospective DiaRegis cohort study included 3807 patients with type 2 diabetes in whom the treating physician decided to intensify and optimize treatment because of insufficient glucose control.
  
  
  RESULTS
  Antidiabetic treatment of overweight and obese patients was compared with that of normal-weight patients over a 2-years follow-up period, and multivariate analyses were performed to identify predictors of body weight loss. Among the 3807 participants, 92.5 % were overweight or obese. Normal-weight participants were more often treated with sulfonylureas or insulin, and overweight and obese patients with metformin or glucagon-like peptide (GLP)-1 analogues. Predictors of weight loss were body mass index (BMI) ≥30 kg/m(2) and any reported physical activity.
  
  
  CONCLUSIONS
  DiaRegis study shows that under real-world conditions, antidiabetic drug therapy is performed dependent on body weight. This strategy results in adequate glucose control and moderate weight reductions in overweight and obese patients. Weight loss is affected by treatment with weight-beneficial drugs, but also by any reported physical activity. However, only a small subgroup of patients perform physical activity. Initiation and maintenance of a physically active lifestyle remains a significant challenge for physicians, and patients with type 2 diabetes.
authors.affiliation: Department of Gastroenterology and Diabetology, Klinikum Ludwigshafen, Bremserstraße 79, 67063, Ludwigshafen, Germany. hartmanb@klilu.de.
authors.forename: B
authors.initials: B
authors.lastname: Hartmann
authors.affiliation: Institute for Pharmacology and Preventive Medicine, Mahlow, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Bramlage
authors.affiliation: Stiftung Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Schneider
authors.affiliation: Herz- und Diabeteszentrum Nordrhein-Westfalen in Bad Oeynhausen, Universitätsklinik der Ruhr Universität Bochum, Bochum, Germany.|Stiftung "Der herzkranke Diabetiker" in der Deutschen Diabetes Stiftung, Bad Oeynhausen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Tschöpe
authors.affiliation: Stiftung Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany.|Department of Cardiology, Herzzentrum Ludwigshafen, Klinikum Ludwigshafen, Ludwigshafen, Germany.
authors.forename: A K
authors.initials: AK
authors.lastname: Gitt
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight / Q000187:drug effects*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy*; D050177:Overweight / Q000188:drug therapy; D011446:Prospective Studies; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents
keywords: Diabetes care guidelines and daily practice; Diabetes treatment; Obesity; Primary care