Study challenges close link between recent weight gain, diabetes

February 11, 2014

It is a common notion that type 2 diabetes is precipitated by substantial progressive weight gain, but a study published this week in PLOS Medicine suggests that this might not be true.

Dorte Vistisen and Kristine Færch, from the Steno Diabetes Center in Gentofte, Denmark, and colleagues analyzed data from participants of the Whitehall II cohort, a group of London-based civil servants who have been followed for more than a decade, to see what changes in body weight and other parameters had occurred in people in the years before they were diagnosed with diabetes.

6,705 participants were free of diabetes when they entered the study and are included in the analysis here. They were tested for diabetes every 5 years, and 645 of them were subsequently diagnosed with the disease. Going back to measurements of (or BMI, calculated using height and weight) which were recorded regularly, the researchers used a statistical method to identify patterns of change in BMI among individuals who went on to develop diabetes.

They identified three groups: by far the largest (comprising 606 individuals) were "stably overweight", and showed little change in their BMI over the years before they were diagnosed with diabetes. A second, much smaller group (15 participants) had gained weight continuously in the years before diagnosis. The remaining 26 participants were persistently obese for the entire time they participated in the study, in some cases for 18 years before they developed diabetes.

Because the three distinct patterns of obesity development were accompanied by different changes over time in insulin resistance and other risk factors for heart disease and diabetes, the authors conclude that " is a not a single disease entity, but rather a heterogeneous disease with different pathophysiological pathways depending on the level and development of obesity."

This study is the first one to apply this methodology to the question of how weight changes relate to the development of diabetes, and it used data from a homogeneous group of all-white civil servants. Before drawing firm conclusions on the process of diabetes development, it will be important to confirm the results in additional and more diverse populations.

Nonetheless, the results are provocative and should stimulate debate on how best to identify people at risk for and how to prevent the disease or delay its onset. The authors suggest that "strategies focusing on small weight reductions for the entire population may be more beneficial than predominantly focusing on loss for high-risk individuals."

Explore further: No evidence of survival advantage for type 2 diabetes patients who are overweight or obese

More information: Vistisen D, Witte DR, Taba´k AG, Herder C, Brunner EJ, et al. (2014) Patterns of Obesity Development before the Diagnosis of Type 2 Diabetes: The Whitehall II Cohort Study. PLoS Med 11(2): e1001602. DOI: 10.1371/journal.pmed.1001602

Related Stories

No evidence of survival advantage for type 2 diabetes patients who are overweight or obese

January 15, 2014
Being overweight or obese does not lead to improved survival among patients with type 2 diabetes. The large-scale study led by Harvard School of Public Health (HSPH) researchers refutes previous studies that have suggested ...

Obesity and mortality association differs between individuals with and without diabetes

August 12, 2013
The relationship between body mass index (BMI) appears to be stronger in adults without diabetes than those with existing diabetes. These findings¹ are published in the Journal of General Internal Medicine in a study by ...

Most patients at diabetes risk consider themselves healthy

January 24, 2014
(HealthDay)—Nearly 80 percent of patients at elevated risk for type 2 diabetes think they are in excellent or very good health, according to a new survey from the American Diabetes Association (ADA).

Waist circumference linked to diabetes risk, independently of body mass index

June 5, 2012
A collaborative re-analysis of data from the InterAct case-control study conducted by Claudia Langenberg and colleagues has established that waist circumference is associated with risk of type 2 diabetes, independently of ...

Genetic factors conferring diabetes don't affect progression

January 17, 2014
(HealthDay)—Genetic variants that predispose to diabetes are not associated with the rate of progression from diabetes to requirement of insulin treatment, according to a study published online Nov. 1 in Diabetes Care.

Testing whether vitamin D delays onset of diabetes

January 9, 2014
Northwestern Medicine is looking for volunteers to take part in the first definitive, large-scale clinical trial to investigate if a vitamin D supplement helps to delay or prevent the onset of type 2 diabetes in adults who ...

Recommended for you

Diabetes can be tracked with our Google searches

July 26, 2017
The emergence of Type 2 Diabetes could be more effectively monitored using our Google searches—helping public health officials keep track of the disease and halt its spread—according to research by the University of Warwick.

Scientists discover a new way to treat type 2 diabetes

July 21, 2017
Medication currently being used to treat obesity is also proving to have significant health benefits for patients with type 2 diabetes. A new study published today in Molecular Metabolism explains how this therapeutic benefit ...

Alzheimer's drug cuts hallmark inflammation related to metabolic syndrome by 25 percent

July 20, 2017
An existing Alzheimer's medication slashes inflammation and insulin resistance in patients with metabolic syndrome, a potential therapeutic intervention for a highly dangerous condition affecting 30 percent of adults in the ...

Diabetes or its precursor affects 100 million Americans

July 19, 2017
Almost one-third of the US population—100 million people—either has diabetes or its precursor condition, known as pre-diabetes, said a government report Tuesday.

One virus may protect against type 1 diabetes, others may increase risk

July 11, 2017
Doctors can't predict who will develop type 1 diabetes, a chronic autoimmune disease in which the immune system destroys the cells needed to control blood-sugar levels, requiring daily insulin injections and continual monitoring.

Diabetes complications are a risk factor for repeat hospitalizations, study shows

July 7, 2017
For patients with diabetes, one reason for hospitalization and unplanned hospital readmission is severe dysglycemia (uncontrolled hyperglycemia - high blood sugar, or hypoglycemia - low blood sugar), says new research published ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.