Weight Change in Diabetes and Glycemic and Blood Pressure Control
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- Adrianne C. Feldstein
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
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- Gregory A. Nichols
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
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- David H. Smith
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
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- Victor J. Stevens
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
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- Keith Bachman
- Northwest Permanente, Portland, Oregon
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- A. Gabriela Rosales
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
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- Nancy Perrin
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
Description
<jats:p>OBJECTIVE—Weight loss in type 2 diabetes is undisputedly important, and data from community settings are limited. We evaluated weight change and resulting glycemic and blood pressure control in type 2 diabetic patients at an HMO.</jats:p> <jats:p>RESEARCH DESIGN AND METHODS—Using electronic medical records, this retrospective cohort study identified 2,574 patients aged 21–75 years who received a new diagnosis of type 2 diabetes between 1997 and 2002. We estimated 3-year weight trajectories using growth curve analyses, grouped similar trajectories into four categories using cluster analysis, compared category characteristics, and predicted year-4 above-goal A1C and blood pressure by group.</jats:p> <jats:p>RESULTS—The weight-trajectory groups were defined as higher stable weight (n = 418; 16.2%), lower stable weight (n = 1,542; 59.9%), weight gain (n = 300; 11.7%), and weight loss (n = 314; 12.2%). The latter had a mean weight loss of 10.7 kg (−9.8%; P < 0.001) by 18 months, with near-complete regain by 36 months. After adjusting for age, sex, baseline control, and related medication use, those with higher stable weight, lower stable weight, or weight-gain patterns were more likely than those who lost weight to have above-goal A1C (odds ratio [OR] 1.66 [95% CI 1.12–2.47], 1.52 [1.08–2.14], and 1.77 [1.15–2.72], respectively). Those with higher stable weight or weight-gain patterns were more likely than those who lost weight to have above-goal blood pressure (1.83 [1.31–2.57] and 1.47 [1.03–2.10], respectively).</jats:p> <jats:p>CONCLUSIONS—A weight-loss pattern after new diagnosis of type 2 diabetes predicted improved glycemic and blood pressure control despite weight regain. The initial period postdiagnosis may be a critical time to apply weight-loss treatments to improve risk factor control.</jats:p>
Journal
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- Diabetes Care
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Diabetes Care 31 (10), 1960-1965, 2008-10-01
American Diabetes Association
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Details 詳細情報について
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- CRID
- 1363388844191747840
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- ISSN
- 19355548
- 01495992
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- Data Source
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- Crossref