Thursday, January 3, 2013

Research Briefs: Weight change following diagnosis of Type 2 Diabetes

I recently reviewed an article for the Evidence Analysis Library related to diabetes. The authors, Adrianne C Feldstein et al investigated weight change patterns in a cohort of patients recently diagnosed with type 2 diabetes. Participants were from an HMO in Oregon and Washington states.

Based on weight measurements preceding and following diagnosis, the 4k participants were categorized into four groups; those who maintained a higher stable weight, those who maintained a lower stable weight, those who lost weight and those who gained weight. 

One finding from this study is that a visit with a dietitian nearly doubled the odds ratio of being in the weight loss group vs. the weight gain group. Being equipped with the knowledge needed to manage your blood sugar and weight is vital to success. Females were more likely to be in the weight loss group.

Patients with depression, who had quit smoking and were lower income were more likely to be in the weight gain group.

One limitation to this study is that it isn't comparing the participants with insurance to those without insurance; all participants in this study had health insurance. Having health insurance makes is much easier for the patient to afford medications and testing supplies to manage their diabetes. 

Weight loss is crucial to patients' health with diabetes. While it was a minority of the patients in this study who were able to achieve and maintain weight loss, it can be done. I would encourage clinicians to consistently:
  • inform their patients of the diabetes diagnosis
  • refer patients to weight loss counseling
  • refer patients to nutrition education
  • follow up with HbA1c every 3-6 months
Please use the following link to find a dietitian in your area.

Citation: Feldstein AC, Nichols GA, Smith DH, Rosales AG, Perrin N. Weight change and glycemic control after diagnosis of type 2 diabetes. J Gen Intern Med 2008;23(9):1339-45.

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