Prediagnosis weight loss not related to increased mortality risk in T2DM patients
No association exists between weight loss prior to type 2 diabetes mellitus (T2DM) diagnosis and heightened mortality risk in normal weight patients with T2DM, reports a study, highlighting the value of addressing risk factors postdiagnosis for excess mortality in this group.
A total of 145,058 patients (mean age at diagnosis 52 years; 56 percent male; 52 percent current or ex-smokers; 66 percent obese; mean body mass index [BMI], 33 kg/m2) participated in the study.
A small but significant reduction in body weight occurred 6 months before diagnosis in normal weight and overweight patients. There was a consistent increase in body weight among all categories of obese patients within the same time window.
Among those who did not lose body weight prior to diagnosis (n=117,469), normal weight patients had 35-percent (hazard ratio, 1.35; 95 percent CI, 1.17–1.55) significantly higher adjusted mortality risk than grade 1 obese patients. On the other hand, there was no association between BMI at diagnosis and mortality risk (p>0.05 for all) among patients who lost weight prediagnosis (n=27,589).
“Undiagnosed comorbid diseases that independently lead to weight loss before T2DM diagnosis could explain the observed increased mortality risk in T2DM patients with normal weight,” the authors said.
In this longitudinal cohort study, patients with newly diagnosed T2DM from January 2000 and without established disease history at diagnosis (defined as the presence of cardiovascular diseases, cancer and renal disease on or before diagnosis) were followed up to 2014.
The authors obtained longitudinal 6-monthly measures of body weight 3 years before (used to define groups of patients who lost body weight or not before diagnosis) and 2 years after diagnosis. All-cause mortality was the primary outcome.