Few newly diagnosed type 2 diabetics succeed in losing weight – weight gain linked to much higher risk of complications

A register-based study from Finland identified three distinct BMI trajectory groups among patients with newly diagnosed type 2 diabetes. In a four-year follow-up, most patients followed a stable trajectory without much weight change. Only 10% of patients lost weight, whereas 3% gained weight. Mean BMI exceeded the threshold of obesity in all groups at baseline. Weight loss is a central treatment goal in type 2 diabetes, but the study shows that few patients succeed in it.

The study was carried out by researchers at the University of Eastern Finland, and the results were published in Clinical Epidemiology.

Patients belonging to each trajectory group were followed up for another eight years for diabetes complications. During the follow-up, 13% of all patients developed microvascular complications, 21% developed macrovascular complications and 20% of patients deceased. The risk of microvascular complications was 2.9 times higher and the risk of macrovascular complications 2.5 times higher among patients with an increasing BMI compared to those with a stable BMI. Micro- and macrovascular complications of diabetes can include, for example, retinopathy, nephropathy and neuropathy, as well as cardiovascular diseases.

“These results underscore the significance of continuous BMI monitoring and weight management in patients with type 2 diabetes. Tailored treatments and support with lifestyle changes are crucial for efficiently preventing weight gain and reducing the risk of diabetes complications,” says Doctoral Researcher Zhiting Wang of the University of Eastern Finland.

The study was carried out in North Karelia, Finland, using electronic health records from both primary and specialised health care. The study included a total of 889 adults with newly diagnosed type 2 diabetes in 2011 or 2012. The participants were grouped based on individual BMI trajectories from the diagnosis until 2014. Risks for microvascular complications, macrovascular complications, any diabetes complications and all-cause mortality from 2015 to 2022 across BMI trajectory groups were estimated.