Weight gain still on the increase in diabetic population
MedWire News: The average weight of the UK diabetic population continuously increased between 1995 and 2010, shows a study published in Diabetes, Obesity and Metabolism.
The findings also reveal that there were considerable differences in the impact of alternative treatment regimens on weight among this population, yet glycemic control remained relatively unchanged.
Craig Currie (Cardiff University, UK) and colleagues used data extracted from the UK General Practice Research Database to determine trends in weight change for each year from 1995 to 2010 for both prevalent and incident cases of diabetes.
The team measured weight change from baseline (defined as the date individuals started treatment) to 6, 12, and 24 months, and also monitored changes from baseline in glycated hemoglobin (HbA1c) in relation to the following treatment categories: exenatide, dipeptidyl peptidase-4 (DPP-4) inhibitors, insulin, metformin, thiazolidinedione (TZD), sulfonylurea, and oral antidiabetes agents.
The researchers report that there was a continual increase in weight for all diabetes patients between 1995 and 2010. The mean weight in the prevalent cohort increased from 83.4 to 92.1 kg in males and from 73.5 to 79.9 kg in females, and in the incident cohort it increased from 86.7 to 93.6 kg in males and from 76.0 to 80.7 kg in females.
At 6 months, patients on a combination of metformin, insulin, sulfonylurea, and TZD had gained the most weight (2.6 kg) while those on a combination of metformin, insulin, and exenatide had lost the most weight (5.0 kg).
At 12 months, it was patients on a combination of insulin and TZD who had gained the most weight (4.1 kg) and those on metformin plus exenatide who had lost the most (7.0 kg).
And at 24 months, the greatest weight gain (6.0 kg) was with a combination of metformin, insulin, sulfonylurea, and TZD, and the greatest loss (8.7 kg) was with metformin and exenatide.
The authors also found that, from baseline to 24 months, the mean glycated hemoglobin (HbA1c) level remained stable at 8.3% for patients treated with insulin, fell from 7.7% to 7.1% with metformin, and from 8.3% to 7.6% with a combination of metformin and sulfonylurea.
"The analysis broadly confirmed clinical trial experience, with regimens involving metformin, exenatide, and DPP-4 inhibitors associated with weight loss, and insulin, sulphonylurea, and the TZDs associated with weight gain," note the authors.
However, the Type 2 diabetes population is continuously increasing in weight, they say, and "there is depressingly little evidence that any treatment regimen is impacting upon what is conventionally the primary purpose of diabetes-related treatment, that is, glucose control," they remark.
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By Sally Robertson