Impact of weight changes on the incidence of diabetes mellitus: a Korean nationwide cohort study

Abstract

Obesity is a well-known risk factor for type 2 diabetes, but few data exist on the association between weight changes and diabetes risk in non-obese subjects. This study aimed to investigate the effect of weight changes on the incidence of type 2 diabetes in Korea, using 51,405 non-diabetic subjects. Individuals who developed type 2 diabetes were more likely to be older and male, to have high body mass index (BMI), blood pressure, fasting blood glucose, and total cholesterol, to be current smokers and frequent drinkers, to be hypertensive and hyperlipidemic, and to have a family history of diabetes, compared to those without type 2 diabetes. Compared with the consistently non-obese group, there was a higher hazard ratio for incident diabetes (95% confidence interval) in subjects becoming obese [1.49 (1.26–1.77)] and remaining obese [2.56 (2.34–2.81)] after adjustment for confounding factors. Decreased BMI was significantly associated with lower risks for incident diabetes and the trends were more evident in the non-obese group. However, overall there was no significant association of increased BMI with incident diabetes. In conclusion, weight loss was significantly associated with lower risk for diabetes both in non-obese and obese Koreans, but particularly in the non-obese.

Intentional weight loss as a predictor of type 2 diabetes occurrence in a general adult population

“…Approximately half of the studies reported that WLW is related to a reduced T2D incidence. [8][9][10][11][12] These studies were all based on large samples (n=1929-114 281) from established cohort studies, for example, Nurses' Health Study, 8 The Health Professionals Follow-up Study, 10 National Health and Nutrition Examination Survey 12 and The British Regional Heart Study. 11 Other studies have failed to find any association between WLW and T2D.…”

“…Epidemiology/Health services research (HR of intervention group vs control group 0.61; 95% CI 0.48 to 0.79; p<0.001). 7 These findings are supported in part [8][9][10][11][12] but not all [13][14][15][16] cohort studies with weight loss without information on intentionality (WLW) as an exposure. In these WLW studies, as no information exists on the intentionality of weight loss, the weight-losers may also include individuals with unintentional weight loss.…”

The Pathophysiology of Type 2 Diabetes Mellitus in Non-obese Individuals: An Overview of the Current Understanding

“…Practically speaking, this should be individualized. While some studies have shown that weight loss is significantly associated with a lower risk for diabetes both in obese and non-obese patients, others have reported adverse effects of losing weight in lean patients [26]. The major pathophysiology appears to be a rapid beta-cell failure due to higher prevalence and early initiation of insulin use.…”

Underweight and low waist circumference prior to percutaneous coronary intervention increase the risk for end-stage renal disease: A Nationwide Population Based-cohort Study

“…Type 2 DM was de ned as an FPG level ≥ 126 mg/dL or at least one claim per year for the prescription of hypoglycemic drug under ICD-10 codes E11-14. [19] Patients with type 1 DM who had claims under ICD-10 code E10 were excluded from this study. [20,21] The group with DM < 5 years was de ned as who had type 2 DM with 5 years on the date of the health checkup.…”