Weight Change, Lifestyle, and Mortality in Patients With Type 2 Diabetes

The association between weight change and mortality among participants with incident type 2 diabetes (T2D) was unclear. To examine above association and evaluate the impact of lifestyle on it. This prospective analysis included 11 262 incident T2D patients from Nurses' Health Study and Health P...

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Bibliographic Details
Published in:The journal of clinical endocrinology and metabolism 2022-02, Vol.107 (3), p.627-637
Main Authors: Hu, Jinbo, Hu, Yang, Hertzmark, Ellen, Yuan, Chen, Liu, Gang, Stampfer, Meir J, Rimm, Eric B, Hu, Frank B, Wang, Molin, Sun, Qi
Format: Article
Language:English
Subjects:
Aged
Analysis
Body weight
Clinical
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - epidemiology
Exercise
Female
Follow-Up Studies
Healthy Lifestyle
Humans
Incidence
Male
Massachusetts
Medical personnel
Medical research
Medicine, Experimental
Middle Aged
Mortality
Patient outcomes
Physical fitness
Proportional Hazards Models
Prospective Studies
Risk Assessment - statistics & numerical data
Risk Factors
Type 2 diabetes
Weight Loss
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Summary:The association between weight change and mortality among participants with incident type 2 diabetes (T2D) was unclear. To examine above association and evaluate the impact of lifestyle on it. This prospective analysis included 11 262 incident T2D patients from Nurses' Health Study and Health Professionals Follow-up Study. We assessed weight change bracketing T2D diagnosis in relation to mortality. We also examined potential effect modification by a healthy lifestyle consisting of high-quality diet, regular physical activity, nonsmoking status, and moderate alcohol consumption. On average, T2D patients lost 2.3 kg during a 2-year time window spanning the T2D diagnosis, and body weight increased afterwards following a trajectory similar to that of nondiabetics. Compared with patients with a stable weight, T2D patients who lost ≥10% body weight had a 21% (95% CI, 9%-35%) increased all-cause mortality. Lifestyle significantly modified these associations: the hazard ratios (95% CIs) of all-cause mortality comparing ≥10% weight loss with stable weight were 1.63 (1.26-2.09) among participants with a deteriorated lifestyle, 1.27 (1.11-1.46) for a stable lifestyle, and 1.02 (0.81-1.27) for an improved lifestyle (Pinteraction < 0.001). Major weight loss was associated with increased cause-specific mortality and similar effect modifications by lifestyle were also observed. Significant weight loss upon T2D incidence was associated with increased mortality, although improved lifestyle quality abolished these associations. These results highlight the role of adopting a healthy lifestyle for newly diagnosed T2D patients, especially among those who might lose weight unintentionally, and improving long-term survival.
ISSN:0021-972X
1945-7197
DOI:10.1210/clinem/dgab800