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Relation of weight gain and weight loss on subsequent diabetes risk in overweight adults
  1. Helaine E Resnicka,
  2. Paola Valsaniab,
  3. Jeffrey B Halterc,
  4. Xihong Lind
  1. aMedStar Research Institute, 108 Irving Street, NW, Washington, DC 20010, USA, bCenter for Health Outcomes and Evaluation, Plymouth, MI, USA, cInstitute of Gerontology, Department of Internal Medicine, Division of Geriatric Medicine, University of Michigan, and VA Medical Center, Ann Arbor, MI, USA, dDepartment of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
  1. Dr Resnick (her1{at}mhg.edu)

Abstract

STUDY OBJECTIVE To determine whether long term weight gain and weight loss are associated with subsequent risk of type 2 diabetes in overweight, non-diabetic adults.

DESIGN Prospective cohort. Baseline overweight was defined as BMI⩾27.3 for women and BMI⩾27.8 for men. Annual weight change (kg/year) over 10 years was calculated using measured weight at subjects' baseline and first follow up examinations. In the 10 years after measurement of weight change, incident cases of diabetes were ascertained by self report, hospital discharge records, and death certificates.

SETTING Community.

PARTICIPANTS 1929 overweight, non-diabetic adults.

MAIN RESULTS Incident diabetes was ascertained in 251 subjects. Age adjusted cumulative incidence increased from 9.6% for BMI<29 to 26.2% for BMI⩾37. Annual weight change over 10 years was higher in subjects who become diabetic compared with those who did not for all BMI<35. Relative to overweight people with stable weight, each kg of weight gained annually over 10 years was associated with a 49% increase in risk of developing diabetes in the subsequent 10 years. Each kg of weight lost annually over 10 years was associated with a 33% lower risk of diabetes in the subsequent 10 years.

CONCLUSIONS Weight gain was associated with substantially increased risk of diabetes among overweight adults, and even modest weight loss was associated with significantly reduced diabetes risk. Minor weight reductions may have major beneficial effects on subsequent diabetes risk in overweight adults at high risk of developing diabetes.

  • obesity
  • diabetes

https://doi.org/10.1136/jech.54.8.596

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    Footnotes

    • Funding: this research was supported by Multidisciplinary Training Grant in Aging (no AG-00114) from the National Institute on Aging, an AARP/Andrus Foundation Graduate Fellowship, and a Blue Cross and Blue Shield of Michigan Student Award Program Grant (no 275-SAP/97) to Dr Resnick.

    • Conflicts of interest: none.