Behaviour change, weight loss and remission of type 2 diabetes: a community based prospective cohort study
Behaviour change, weight loss and remission of type 2 diabetes: a community based prospective cohort study
Aim: To quantify the association between behaviour change and weight loss after diagnosis of Type 2 diabetes, and the likelihood of remission of diabetes at 5-year follow-up. Method: We conducted a prospective cohort study in 867 people with newly diagnosed diabetes aged 40–69 years from the ADDITION-Cambridge trial. Participants were identified via stepwise screening between 2002 and 2006, and underwent assessment of weight change, physical activity (EPAQ2 questionnaire), diet (plasma vitamin C and self-report), and alcohol consumption (self-report) at baseline and 1 year after diagnosis. Remission was examined at 5 years after diabetes diagnosis via HbA
1c level. We constructed log binomial regression models to quantify the association between change in behaviour and weight over both the first year after diagnosis and the subsequent 1–5 years, as well as remission at 5-year follow-up. Results: Diabetes remission was achieved in 257 participants (30%) at 5-year follow-up. Compared with people who maintained the same weight, those who achieved ≥ 10% weight loss in the first year after diagnosis had a significantly higher likelihood of remission [risk ratio 1.77 (95% CI 1.32 to 2.38; p<0.01)]. In the subsequent 1–5 years, achieving ≥10% weight loss was also associated with remission [risk ratio 2.43 (95% CI 1.78 to 3.31); p<0.01]. Conclusion: In a population-based sample of adults with screen-detected Type 2 diabetes, weight loss of ≥10% early in the disease trajectory was associated with a doubling of the likelihood of remission at 5 years. This was achieved without intensive lifestyle interventions or extreme calorie restrictions. Greater attention should be paid to enabling people to achieve weight loss following diagnosis of Type 2 diabetes.
681-688
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Day, Alexander J.
3bc77f70-aa1d-4b37-b70d-2655b5eeb410
Strelitz, Jean
893ce116-331a-45a4-bd2a-bbce07f7bf9b
Irving, Greg
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Griffin, Simon J.
f12ee1b9-fef5-46ab-b5a4-50b66e6c93c8
1 April 2020
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Day, Alexander J.
3bc77f70-aa1d-4b37-b70d-2655b5eeb410
Strelitz, Jean
893ce116-331a-45a4-bd2a-bbce07f7bf9b
Irving, Greg
b99b9b55-55b1-4656-9e30-fe0acaa5aa6f
Griffin, Simon J.
f12ee1b9-fef5-46ab-b5a4-50b66e6c93c8
Dambha-Miller, Hajira, Day, Alexander J., Strelitz, Jean, Irving, Greg and Griffin, Simon J.
(2020)
Behaviour change, weight loss and remission of type 2 diabetes: a community based prospective cohort study.
Diabetic Medicine, 37 (4), .
(doi:10.1111/dme.14122).
Abstract
Aim: To quantify the association between behaviour change and weight loss after diagnosis of Type 2 diabetes, and the likelihood of remission of diabetes at 5-year follow-up. Method: We conducted a prospective cohort study in 867 people with newly diagnosed diabetes aged 40–69 years from the ADDITION-Cambridge trial. Participants were identified via stepwise screening between 2002 and 2006, and underwent assessment of weight change, physical activity (EPAQ2 questionnaire), diet (plasma vitamin C and self-report), and alcohol consumption (self-report) at baseline and 1 year after diagnosis. Remission was examined at 5 years after diabetes diagnosis via HbA
1c level. We constructed log binomial regression models to quantify the association between change in behaviour and weight over both the first year after diagnosis and the subsequent 1–5 years, as well as remission at 5-year follow-up. Results: Diabetes remission was achieved in 257 participants (30%) at 5-year follow-up. Compared with people who maintained the same weight, those who achieved ≥ 10% weight loss in the first year after diagnosis had a significantly higher likelihood of remission [risk ratio 1.77 (95% CI 1.32 to 2.38; p<0.01)]. In the subsequent 1–5 years, achieving ≥10% weight loss was also associated with remission [risk ratio 2.43 (95% CI 1.78 to 3.31); p<0.01]. Conclusion: In a population-based sample of adults with screen-detected Type 2 diabetes, weight loss of ≥10% early in the disease trajectory was associated with a doubling of the likelihood of remission at 5 years. This was achieved without intensive lifestyle interventions or extreme calorie restrictions. Greater attention should be paid to enabling people to achieve weight loss following diagnosis of Type 2 diabetes.
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Dambha-Miller_et_al-2019-Diabetic_Medicine
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Accepted/In Press date: 13 August 2019
e-pub ahead of print date: 3 September 2019
Published date: 1 April 2020
Additional Information:
Funding Information:
ADDITION‐Cambridge was supported by the Wellcome Trust (grant reference no: G061895), the Medical Research Council (grant reference no: G0001164 and Epidemiology Unit programme: MC_UU_12015/4), the National Institute for Health Research (NIHR) Health Technology Assessment Programme (grant reference no: 08/116/300), NIHR Programme Grants for Applied Research (RP‐PG‐0606‐1259) National Health Service R&D support funding (including the Primary Care Research and Diabetes Research Networks) and the NIHR. S.J.G. is an NIHR Senior Investigator. The University of Cambridge has received salary support in respect of S.J.G. from the NHS in the East of England through the Clinical Academic Reserve. Bio‐Rad provided equipment for HbA 1c testing during the screening phase. The Primary Care Unit is a member of the NIHR School for Primary Care Research and supported by NIHR Research funds. G.I. was an NIHR Clinical Lecturer. H.D.M. was an NIHR Doctoral Research Fellow at the time of this study and is now an NIHR Clinical Lecturer. J.S. is supported by an MRC Epidemiology Unit Core programme MC_UU_12015/4 fellowship. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The sponsor had no role in study data collection, data analysis, data interpretation, or writing of the findings. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Funding Information:
S.J.G. reports grants from the Wellcome Trust, Medical Research Council, NIHR, NIHR Health Technology Assessment Programme, NHS R&D and the University of Aarhus (Denmark), and provision of equipment from Bio‐Rad during the conduct of the study. Outside the submitted work he also reports receiving fees from Novo Nordisk, Astra Zeneca and Napp for speaking at postgraduate education meetings, support to attend a scientific meeting from Napp, and an honorarium and reimbursement of travel expenses from Eli Lilly, associated with membership of an independent data monitoring committee for a randomized trial of a medication to lower glucose.
Publisher Copyright:
© 2019 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK
Identifiers
Local EPrints ID: 433283
URI: http://eprints.soton.ac.uk/id/eprint/433283
ISSN: 0742-3071
PURE UUID: afa4cc9a-4b76-4a13-97b2-cc176ad7d71b
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Date deposited: 13 Aug 2019 16:30
Last modified: 16 Mar 2024 08:07
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Author:
Alexander J. Day
Author:
Jean Strelitz
Author:
Greg Irving
Author:
Simon J. Griffin
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