Losing Weight Early Improves Health Later

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Weight change in diabetes and glycemic and blood pressure control, by Adrianne C. Feldstein and colleagues. Diabetes Care 31:1960–1965, 2008

What is the problem and what is known about it so far?

Nearly all adults with diabetes are overweight, and more than half are very overweight, which is considered obese. People who are obese are more likely to get heart disease. In research studies, losing weight has been shown to improve blood glucose, blood pressure, and cholesterol levels and lower the risk of heart disease in people with type 2 diabetes. Less is known about the health effects of weight loss among people in the course of ordinary community life rather than in research studies.

Why did researchers do this particular study?

The researchers wanted to find out how weight changes affect blood glucose and blood pressure control among patients with type 2 diabetes at a health maintenance organization (HMO).

Who was studied?

More than 2,500 adult patients who were diagnosed with type 2 diabetes between 1997 and 2002 were studied

How was the study done?

Researchers collected information from electronic medical records to estimate the patients' 3-year weight change patterns. They grouped patients with similar weight profiles into four categories and then compared how their weight changes affected their blood glucose and blood pressure levels.

What did the researchers find?

After taking many other factors into account, patients with higher stable weights, lower stable weights, or weight gains during the 3 years after diabetes diagnosis were more likely than those with weight losses to have above-goal A1C levels in the fourth year. Those with higher stable weights or weight gains were also more likely than those who lost weight to have above-goal blood pressure readings in the fourth year. These findings were true even though the patients with weight losses generally regained their lost weight by the end of the third year.

What were the limitations of the study?

The study was done at an HMO in two states, so its results may not apply to patients in different settings. The study included only HMO patients who continued living for the length of the study, so it did not assess how weight change might have affected health in those who died. Finally, information was collected during regular clinic visits and therefore might not have been as accurate as it would have been if collected during a clinical research trial.

What are the implications of the study?

Losing weight after a new diagnosis of type 2 diabetes can have long-lasting health benefits, even if the lost weight is eventually regained. Helping diabetic patients lose weight soon after they are diagnosed may reduce their risk for heart disease later.

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