Abstract

Objective Weight loss in type 2 diabetes is undisputedly important. Data from community settings describing weight change, and resulting glycemic and blood pressure control, in these patients are limited.

Research Design and Methods Using electronic medical records, this retrospective cohort study identified 2574 patients aged 21-75 who received a new diagnosis of type 2 diabetes between 1997 and 2002. We estimated 3-year weight trajectories using growth curve analyses, grouped similar trajectories into 4 categories using cluster analysis, compared category characteristics, and predicted year-4 above-goal HbA_1c and blood pressure by group.

Results The weight-trajectory groups were defined as “higher stable weight” (n=418; 16.2%), “lower stable weight” (n=1542; 59.9%), “weight gain” (n=300; 11.7%), and “weight loss” (n=314; 12.2%). The latter had a mean weight loss of 10.7 kg (-9.8%; p<0.001) by 18 months, with near-complete regain by 36 months. After adjusting for age, gender, baseline control, and related-medication use, those with higher stable weight, lower stable weight, or weight gain patterns were more likely than weight losers to have above-goalHbA_1c (OR 1.66, CI 1.12-2.47; OR 1.52, CI 1.08-2.14; OR 1.77, 1.15-2.72). Those with higher stable weight or weight-gain patterns were more likely than weight losers to have above-goal blood pressure (OR 1.83, CI 1.31-2.57; OR 1.47, CI 1.03-2.10).

Conclusions. A weight-loss pattern after new diagnosis of type 2 diabetes predicted improved glycemic and blood pressure control despite weight regain. The initial period post-diagnosis may be a critical time to apply weight loss treatments to improve risk factor control.