Weight Change in Diabetes and Glycemic and Blood Pressure Control

Feldstein, Adrianne C.; Nichols, Gregory A.; Smith, David H.; Stevens, Victor J.; Bachman, Keith H.; Rosales, A. Gabriela; Perrin, Nancy

doi:10.2337/dc08-0426

Cited by 125 publications

(94 citation statements)

References 23 publications

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“…9 The current study also provides new evidence that the probability of stable weight maintenance in adults with diabetes over 10 years is highest in those who were initially of normal weight (28.7 %) or overweight (46.2 %).…”

Section: Discussionmentioning

confidence: 53%

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

Chiu

Wray

et al. 2013

J GEN INTERN MED

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BACKGROUND: Few longitudinal studies have examined associations between body mass index (BMI) changes in adults with diabetes and the development of disability. OBJECTIVE: To investigate association patterns between BMI and disability in middle-aged adults with diabetes. DESIGN AND SETTING: Retrospective cohort design with data from the 1992-2006 Health and Retirement Study (HRS). A group-based joint trajectory method identified distinct BMI change trajectories and their link to subsequent disability trajectories. PARTICIPANTS: U.S. nationally representative adults aged 51-61 who reported a diagnosis of diabetes in the 1992 HRS (N=1,064). MEASUREMENTS: BMI and self-reported disability score were the main variables. Sociodemographic, clinical, behavioral, and diabetes-related factors were also examined. RESULTS: Four distinct weight trajectories (stable normal weight, 28.7 %; stable overweight, 46.2 %; loss and regain obese, 18.0 %; weight cumulating morbidly obese, 7.1 %) and three disability trajectories (little or low increase, 34.4 %; moderate increase, 45.4 %; chronic high increase, 20.2 %) best characterized the long-term patterns of BMI and disability change in middle-aged adults with diabetes. Adults in stable normal weight had the highest probability of being in the little/low increase disability group; however, one in five adults in that group progressed into chronic high disability, a higher proportion compared to the stable overweight group. CONCLUSIONS: Although there were various ways in which the two trajectories were linked, the beneficial impacts of optimizing weight in adults with diabetes were supported. In addition, the complexity of diabetes control in those with relatively normal weight was highlighted from this study.

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Section: Discussionmentioning

confidence: 53%

“…8,9 However, these studies are limited by relatively short periods of follow-up (1 and 3 years, respectively); thus, weight fluctuations 10 may not be well-detected. In addition, use of medical records rather than population-based data may not capture variations in demographically and geographically heterogeneous adults with diabetes.…”

mentioning

confidence: 99%

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

Chiu

Wray

et al. 2013

J GEN INTERN MED

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“…These findings show that the subjects were overweight or obese. It is estimated that 80% of users with type 2 diabetes mellitus are obese or overweight (14) . The waist circumference ranged from 60 to 140cm, mean 107.06±15.29 cm.…”

Section: Resultsmentioning

confidence: 99%

“…Studies have shown that, in most cases, the diagnosis of type 2 diabetes mellitus is carried out late and that there is an under-diagnosis of this disease. In most cases, when it is diagnosed, the patient already presents some form of complication (10)(11)(12)(13)(14)(15)(16)(17) . By comparing the data from this study, a higher prevalence was observed of individuals who used oral antidiabetics of the sulfonylurea therapeutic class and used insulin and a lower prevalence of individuals using combined therapy (18) .…”

Section: Resultsmentioning

confidence: 99%

Conhecimento e atitude de usuários com diabetes mellitus em um serviço de atenção básica à saúde

Oliveira

Zanetti

2011

Rev. esc. enferm. USP

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Este estudo teve como objetivos caracterizar os usuários com diabetes mellitus tipo 2, segundo variáveis sócio-demográficas e clínicas, e analisar os escores de conhecimento e atitude em relação à doença. Participaram 79 usuários atendidos em um serviço de atenção básica à saúde em 2008. Para a obtenção dos dados, foram utilizados os Questionários de Conhecimento (DKN - A), e de Atitudes Psicológicas do Diabetes (ATT - 19). A população caracterizou-se por adultos e idosos, com idade entre 30 e 80 anos; predominantemente do sexo feminino (63,3%), casada (63,3%) e alfabetizada (96,3%) com obesidade classe II. Quanto ao conhecimento da doença, obtiveram-se escores inferiores a oito, indicando resultado insatisfatório quanto ao autocuidado. Os escores obtidos em relação às atitudes mostram dificuldades para o enfrentamento da doença, apontando os resultados para a necessidade de implantação de Programa de Educação em Diabetes a Unidade de Estudo.

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“…Patients were glycemic control, blood pressure, and lipid outcomes in patients with T2DM. [6][7][8][9] As a result, weight management has become increasingly important in patients with T2DM. [10][11][12] Because of the high costs of care and risk of complications that negatively impact quality of life, T2DM is often a top priority for population management within managed care organizations and for providers.…”

Section: Self-reported Adherencementioning

confidence: 99%

Impact of Adherence and Weight Loss on Glycemic Control in Patients with Type 2 Diabetes: Cohort Analyses of Integrated Medical Record, Pharmacy Claims, and Patient-Reported Data

McAdam‐Marx¹,

Bellows²,

Unni³

et al. 2014

JMCP

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BACKGROUND: Managed care organizations put great effort into managing the population of patients with type 2 diabetes mellitus (T2DM) because of the health and economic burden of this disease. In patients with T2DM, weight loss and glycemic control are primary treatment aims to help improve patient outcomes, but these goals are not easily achieved. While achieving these aims requires a multifaceted approach of drug therapy management and lifestyle modification, truly understanding the role of medication adherence in achieving these outcomes is important for both patient and population management. This study expands on existing evidence that weight loss is associated with improved glycemic control by examining the role of medication adherence in achieving these goals in a managed care setting. This study is unique in that these associations are evaluated using multiple sources of data, including medical records for treatment outcomes, pharmacy claims, and patient-reported data to assess medication adherence. These data sources represent those typically available to payers or providers.OBJECTIVE: To describe the relationships between medication and adherence, weight change, and glycemic control in patients with T2DM.METHODS: This historical cohort study included adult patients with T2DM in a large integrated health system and was based on electronic health record and pharmacy claims data from November 1, 2010, through October 31, 2011, as well as data from a self-reported adherence survey conducted in March 2012. Included patients received a diabetes medication from a therapeutic class not previously received, between November 1, 2010, and April 30, 2011 (index date), who had blood glucose (HbA1c) and weight values at index date and 6 months follow-up, participated in an adherence survey, and had ≥ 1 prescription claim for the index-date drug. Associations between the dual outcomes of weight loss (≥ 3%) and HbA1c control (< 7.0%), while controlling for medication adherence and other demographic, treatment, and clinical variables, were evaluated using structural equation models (SEM). Separate models adjusted for different measures of medication adherence-self-reported using the 5-item Medication Adherence Rating Scale (MARS-5) and a modified medication possession ratio (mMPR) from pharmacy claims data. RESULTS:The study included 166 patients with a mean age of 61.1 (standard deviation = 12.1) years; 56.0% were female. Medication adherence was high, with 72.2% adherent using MARS-5 and 77.1% using mMPR measures. The SEMs found that only self-reported medication adherence is associated with weight loss (MARS-5: OR = 1.70, 95% CI = 1.11-2.60), while both self-reported and claims-based medication adherence were associated with HbA1c < 7.0% (MARS-5: OR = 1.59, 95% CI = 1.09-2.34; mMPR: OR 2.71, 95% CI = 1.22-5.98). Further, weight loss is significantly associated with HbA1c < 7.0% (MARS-5: OR = 3.60, 95% CI = 2.39-5.46; mMPR: OR 2.99, 95% CI = 1.45-6.17).CONCLUSIONS: This study has provided additional evidence ...

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Weight Change in Diabetes and Glycemic and Blood Pressure Control

Cited by 125 publications

References 23 publications

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

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

Conhecimento e atitude de usuários com diabetes mellitus em um serviço de atenção básica à saúde

Impact of Adherence and Weight Loss on Glycemic Control in Patients with Type 2 Diabetes: Cohort Analyses of Integrated Medical Record, Pharmacy Claims, and Patient-Reported Data

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