Unintentional Weight Loss and Mortality in T2D

Overweight and obese type 2 diabetes (T2D) patients are encouraged to lose weight to decrease their mortality risk. In the general population, unintentional weight loss is a risk factor for all-cause mortality. In this study, researchers examined whether this was also true for T2D patients. The study authors reported the findings of the ADVANCE trial, which stratified two-year weight change into five groups: >10% loss, 4% to 10% loss, stable (±<4%), 45 to 10% gain, and >10% gain. Final analysis included 10,081 patients (average age, 66 years). At two-year follow-up, 4.3% had > 10% weight loss, 18.4% had 4% to 10% weight loss, and 5.3% had > 10% weight gain. Three years later, patients with >10% weight loss, compared to those with stable weight, had significantly greater risk for major cardiovascular events (HR=1.75; 95% CI, 1.26 to 1.44), cardiovascular mortality (HR=2.76; 95% CI, 1.87 to 4.09), and all-cause mortality (HR=2.79; 95% CI, 2.10 to 3.79), but not major microvascular events (HR=0.9; 95% CI, 0.61 to 1.36). Data did not support effect modification by baseline body mass index, age, or type of diabetes medication.