@article{513a40b55b8e4199927062fe0c2ced1f,
title = "Association of weight loss and weight loss maintenance following diabetes diagnosis by screening and incidence of cardiovascular disease and all-cause mortality: An observational analysis of the ADDITION-Europe trial",
abstract = "AIMS: Short-term weight loss may lead to remission of type 2 diabetes but the effect of maintained weight loss on cardiovascular disease (CVD) is unknown. We quantified the associations between changes in weight 5 years following a diagnosis of diabetes, and incident CVD events and mortality up to 10 years after diagnosis.MATERIALS AND METHODS: Observational analysis of the ADDITION-Europe trial of 2730 adults with screen-detected type 2 diabetes from the UK, Denmark and the Netherlands. We defined weight change based on the maintenance at 5 years of weight loss achieved during the year after diabetes diagnosis, and as 5-year overall change in weight. Incident CVD events (n = 229) and all-cause mortality (n = 225) from 5 to 10 years follow-up were ascertained from medical records.RESULTS: Gaining >2% weight during the year after diabetes diagnosis was associated with higher hazard of all-cause mortality versus maintaining weight [hazard ratio (95% confidence interval): 3.18 (1.30-7.82)]. Losing ≥5% weight 1 year after diagnosis was also associated with mortality, whether or not weight loss was maintained at 5 years: 2.47 (0.99-6.21) and 2.72 (1.17-6.30), respectively. Losing ≥10% weight over 5 years was associated with mortality among those with body mass index <30 kg/m 2 [4.62 (1.87-11.42)]. Associations with CVD incidence were inconclusive. CONCLUSIONS: Both weight loss and weight gain after screen-detected diabetes diagnosis were associated with higher mortality, but not CVD events, particularly among participants without obesity. The clinical implications of weight loss following a diagnosis of diabetes probably depend on its magnitude and timing, and may differ by body mass index status. Personalization of weight loss advice and support may be warranted.",
keywords = "cardiovascular disease, diabetes complications, type 2 diabetes, weight control, Cardiovascular Diseases/epidemiology, Humans, Risk Factors, Diabetes Mellitus, Type 2/complications, Incidence, Europe/epidemiology, Weight Loss, Adult, Netherlands/epidemiology",
author = "Jean Strelitz and Sharp, {Stephen J.} and Kamlesh Khunti and Vos, {Rimke C.} and Rutten, {Guy E.H.M.} and Webb, {David R.} and Witte, {Daniel R.} and Annelli Sandb{\ae}k and Wareham, {Nicholas J.} and Griffin, {Simon J.}",
note = "Funding Information: We gratefully acknowledge the contribution of all participants, practice nurses and general practitioners in the ADDITION‐Europe study. We are grateful to the independent endpoint committee in Denmark (Professors Kristian Thygesen, Hans Ibsen, Ole F{\ae}rgeman and Birger Thorsteinsson), the UK (Professor Jane Armitage and Dr Louise Bowman) and the Netherlands (Professors Cees Tack and Jaap Kappelle), and the Independent Data Monitoring and Safety Committee (Christian Gluud, Per Winkel and J{\o}rn Wetterslev). We thank Daniel Barnes for contributions to data cleaning. We are grateful to the ADDITION‐Cambridge independent trial steering committee [Nigel Stott (Chair), John Weinman, Richard Himsworth and Paul Little]. Aside from the authors, the ADDITION‐Cambridge study team has included Amanda Adler, Judith Argles, Gisela Baker, Rebecca Bale, Roslyn Barling, Daniel Barnes, Mark Betts, Sue Boase, Clare Boothby, Ryan Butler, Parinya Chamnan, Kit Coutts, Sean Dinneen, Pesheya Doubleday, Mark Evans, Tom Fanshawe, Francis Finucane, Philippa Gash, Julie Grant, Wendy Hardeman, Robert Henderson, Garry King, Ann‐Louise Kinmonth, Joanna Mitchell, Richard Parker, Nicola Popplewell, A. Toby Prevost, Richard Salisbury, Lincoln Sargeant, Rebecca Simmons, Megan Smith, Stephen Sutton, Fiona Whittle and Kate Williams. We thank the following groups within the MRC Epidemiology Unit: data management (Clare Boothby and Adam Dickinson), information technology (Iain Morrison and Rich Hutchinson), technical (Matt Sims) and field epidemiology (James Sylvester, Gwen Brierley, Richard Salisbury and Kit Coutts). This research was funded by the Medical Research Council. ADDITION‐Denmark was supported by the National Health Services in the counties of Copenhagen, Aarhus, Ringk{\o}bing, Ribe, and South Jutland; the Danish Council for Strategic Research; the Danish Research Foundation for General Practice; Novo Nordisk Foundation; the Danish Center for Evaluation and Health Technology Assessment; the diabetes fund of the National Board of Health; the Danish Medical Research Council; and the Aarhus University Research Foundation. Part of the grants from the Novo Nordisk Foundation and the Danish Council for Strategic Research were transferred to the other centres. ADDITION‐Cambridge was supported by the Wellcome Trust (grant reference no: G061895), the Medical Research Council (grant reference no: G0001164), the National Institute for Health Research (NIHR) Health Technology Assessment Programme (grant reference no: 08/116/300), and National Health Service research and development support funding (including the Primary Care Research and Diabetes Research Networks), and the NIHR under its Programme Grants for Applied Research Scheme (RP‐PG‐0606‐1259 to M.J.D. and K.K.). Bio‐Rad provided ADDITION‐Cambridge with the equipment for HbA1c testing during the screening phase. ADDITION‐Netherlands was supported by the Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht. ADDITION‐Leicester was supported by the Department of Health and ad hoc Support Sciences, the NIHR Health Technology Assessment Programme (grant reference no: 08/116/300), and National Health Service research and development support funding (including the Primary Care Research and Diabetes Research Networks Leicestershire, NIHR CLAHRC‐East Midlands, ARC‐East Midlands and the Leicester Lifestyle BRC). Publisher Copyright: {\textcopyright} 2020 John Wiley & Sons Ltd",
year = "2021",
month = mar,
doi = "10.1111/dom.14278",
language = "English",
volume = "23",
pages = "730--741",
journal = "Diabetes, Obesity and Metabolism",
issn = "1462-8902",
publisher = "Wiley-Blackwell",
number = "3",
}