Changes in patient weight and the impact of antidiabetic therapy during the first 5 years after diagnosis of diabetes mellitus

Abstract

Aims/hypothesis It is generally thought difficult for type 2 diabetic patients to lose weight. We monitored changes in patients' weight during the first 5 years after diabetes diagnosis in relation to initiation of antidiabetic treatment. Subjects and methods Data from 711 newly diagnosed diabetic patients aged 40 or over were analysed with a random-effect linear-regression model. Patients were included consecutively from a well-defined patient list in general practice. Results In 245 patients whose only treatment was advice on diet, an initial weight loss of 6 to 7 kg was largely maintained over 5 years. Patients receiving metformin (n=86) or sulfonylureas (n=330) maintained an average weight loss of 2 to 4 kg that was dependent on age and sex. Patients' weight did not change on initiation of treatment with sulfonylureas or metformin. Over 5 years, median HbA 1c increased from 7.0 to 7.8% (reference range 5.4-7.4%) in the diet-alone group. HbA 1c was approximately 1 percentage point higher for most of the other treatment groups. Conclusions/interpretation In newly diagnosed type 2 diabetic patients, long-term weight loss was common and weight loss was not affected by sulfonylurea treatment. The measurements in the study are taken from treatment results achieved in the general population of diabetic patients, who are rarely treated in secondary care and seldom the subject of research; the results thus indicate that weight reduction is a practicable treatment in diabetic patients.

BMI Change Patterns and Disability Development of Middle-aged Adults with Diabetes: A Dual Trajectory Modeling Approach

“…Prior studies have pointed out that anti-hyperglycemic therapies, 6 duration of diabetes, 5 and sex 7 may affect weight change in diabetes patients; results from the present study support and extend previous findings. The weight cumulating morbidly obese group was disproportionately female, members of minority groups, as well as reporting greater comorbid health conditions and being treated with insulin, Table 2 of the supplemental appendix on line.…”

“…Research in clinical and community settings has examined general weight change patterns in adults living with diabetes over time, yielding inconsistent findings [2][3][4][5][6][7] and suggesting that the longitudinal course of body weight in middle-aged and older adults with diabetes exhibits not only intra-individual but also inter-individual variation.…”

Canagliflozin, dapagliflozin and empagliflozin monotherapy for treating type 2 diabetes: systematic review and economic evaluation

“…De Fine Olivarius et al 168 reported that 330 patients did not gain weight after starting on sulfonylureas. They make the point that most patients with type 2 diabetes are treated in primary care and are seldom recruited to trials, and that trials may therefore not be generalisable to all patients.…”

Blood lipid profiles and factors associated with dyslipidemia assessed by a point-of-care testing device in an outpatient setting: A large-scale cross-sectional study in Southern China

“…Oral antidiabetics, incretin-based therapies, and insulin have effects on lipid measurements which differ within and between classes of agents [18]. Furthermore, antidiabetic therapy may have an effect on weight in type 2 diabetes; for example, sulfonylureas or insulin are associated with weight gain while metformin is associated with weight stabilization or weight loss [19]. However, one study of 245 newly diagnosed diabetics who received dietary counseling found that patients did not have a weight change when treatment with sulfonylureas or metformin was begun [19].…”