Association between weight change and remission of type 2 diabetes: a retrospective cohort study in primary care
Association between weight change and remission of type 2 diabetes: a retrospective cohort study in primary care
The purpose of this study was to quantify the association between weight change and the likelihood of remission of type 2 diabetes in a population-based cohort without intensive interventions. We undertook a retrospective analysis of adults with type 2 diabetes registered across 150 primary care practices in Southern England, United Kingdom, within the electronic Care and Health Information Analytics (CHIA) database between 2013 and 2020. Stepwise mixed logistic models were constructed to examine the association between percentage weight change over five-years, and the likelihood of remission in the subsequent two years using four categories: weight gain ≥2.5%; weight loss ≤2.5–5% or ≥5–10% or ≥10%. The study cohort included 56,120 people with type 2 diabetes with a mean (SD) disease duration of 8.0 (6.7) years. In total, 17,035 (30.4%) had microvascular complications and 10,661 (19.0%) had macrovascular complications. A total of 19.4% (10,896) lost ≥10% of their baseline weight with 1646 (15.1%) of these achieving remission. Overall, those who lost ≥10% in weight had a significantly higher likelihood of remission in both unadjusted and adjusted models; RR 1.53 (95% CI 1.40–1.68); and RR 1.51 (95% CI 1.37–1.66), respectively. Remission was still achievable but less likely among younger men with a longer diabetes duration (≥5 years), higher baseline HbA
1c level, or pre-existing microvascular or macrovascular complications. It was concluded weight loss of >10% is associated with remission of type 2 diabetes even among those with advanced disease and established microvascular or macrovascular complications. Our findings could motivate people with diabetes to lose weight in order to increase likelihood of remission.
primary care, remission, type 2 diabetes, weight loss
8-14a
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Hounkpatin, Hilda
5612e5b4-6286-48c8-b81f-e96d1148681d
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Farmer, Andrew
c384123c-1276-4d06-a2b5-d5419bd83b1d
1 September 2021
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Hounkpatin, Hilda
5612e5b4-6286-48c8-b81f-e96d1148681d
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Farmer, Andrew
c384123c-1276-4d06-a2b5-d5419bd83b1d
Dambha-Miller, Hajira, Hounkpatin, Hilda, Stuart, Beth and Farmer, Andrew
(2021)
Association between weight change and remission of type 2 diabetes: a retrospective cohort study in primary care.
Practical Diabetes, 38 (5), .
(doi:10.1002/pdi.2355).
Abstract
The purpose of this study was to quantify the association between weight change and the likelihood of remission of type 2 diabetes in a population-based cohort without intensive interventions. We undertook a retrospective analysis of adults with type 2 diabetes registered across 150 primary care practices in Southern England, United Kingdom, within the electronic Care and Health Information Analytics (CHIA) database between 2013 and 2020. Stepwise mixed logistic models were constructed to examine the association between percentage weight change over five-years, and the likelihood of remission in the subsequent two years using four categories: weight gain ≥2.5%; weight loss ≤2.5–5% or ≥5–10% or ≥10%. The study cohort included 56,120 people with type 2 diabetes with a mean (SD) disease duration of 8.0 (6.7) years. In total, 17,035 (30.4%) had microvascular complications and 10,661 (19.0%) had macrovascular complications. A total of 19.4% (10,896) lost ≥10% of their baseline weight with 1646 (15.1%) of these achieving remission. Overall, those who lost ≥10% in weight had a significantly higher likelihood of remission in both unadjusted and adjusted models; RR 1.53 (95% CI 1.40–1.68); and RR 1.51 (95% CI 1.37–1.66), respectively. Remission was still achievable but less likely among younger men with a longer diabetes duration (≥5 years), higher baseline HbA
1c level, or pre-existing microvascular or macrovascular complications. It was concluded weight loss of >10% is associated with remission of type 2 diabetes even among those with advanced disease and established microvascular or macrovascular complications. Our findings could motivate people with diabetes to lose weight in order to increase likelihood of remission.
Text
remission paper 2 weight loss and remission CHIA paper_Practical Diabetes_CLEAN
- Accepted Manuscript
More information
Accepted/In Press date: 1 May 2021
Published date: 1 September 2021
Additional Information:
Funding Information:
HDM is a National Institute for Health Research (NIHR) funded Academic Clinical Lecturer and has received NIHR SPCR funding to support this work (SPCR2014‐10043).
Funding Information:
AF receives support from NIHR Oxford Biomedical Research Centre.
Publisher Copyright:
Copyright © 2021 John Wiley & Sons, Ltd.
Keywords:
primary care, remission, type 2 diabetes, weight loss
Identifiers
Local EPrints ID: 449409
URI: http://eprints.soton.ac.uk/id/eprint/449409
ISSN: 2047-2897
PURE UUID: e670cdac-020c-46b6-bc57-f8492397109d
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Date deposited: 27 May 2021 16:31
Last modified: 17 Mar 2024 06:35
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Author:
Andrew Farmer
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