Beverly M Kocarnik1, Kathryn P Moore2, Nicholas L Smith3, Edward J Boyko4. 1. General Medicine and Hospital and Specialty Medicine Services, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Division of Endocrinology, Metabolism and Nutrition, Department of Medicine, University of Washington, Seattle, WA, USA; Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA. 2. Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA. 3. Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA; Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA. 4. General Medicine and Hospital and Specialty Medicine Services, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, USA. Electronic address: eboyko@uw.edu.
Abstract
PURPOSE: To investigate whether weight change in the first year after initiating an oral hypoglycemic agent (OHA) for type 2 diabetes treatment is associated with mortality in a national cohort. PROCEDURES: We prospectively followed Veterans Health Administration patients with type 2 diabetes initiating treatment with an OHA and not receiving any other diabetes pharmacotherapy for at least one year. Information on OHAs, weight, co-morbidities, other medications, demographics, and laboratory measurements was obtained from electronic medical records. Logistic regression was used to estimate 5-year mortality odds by weight change during the first year after OHA treatment initiation. FINDINGS: Patients (mean age 65years, 97% male, mean BMI 32.3kg/m2) initiating OHA monotherapy between 2003 and 2008 totaled 145,198 (metformin n=89,111, glipizide n=27,100, glyburide n=25,226, rosiglitazone n=3,761). Most patients (65%) maintained a stable weight (change ⩽5% from baseline) during the first year after OHA initiation. Those losing >5% of baseline weight had a significantly higher odds of death over the subsequent 5-years ranging from 1.64 to 2.13 depending on OHA type. In the metformin group, weight gain >5% of baseline was also associated with higher odds of 5-year mortality. The same results were obtained after conducting three sensitivity analyses that excluded patients for the following reasons: weight loss in the one year prior to OHA initiation, weight change >100lbs, or weight change >50lbs. CONCLUSIONS: Weight loss was associated with higher odds of 5-year mortality among patients initiating an OHA, as was weight gain for metformin only. Published by Elsevier B.V.
PURPOSE: To investigate whether weight change in the first year after initiating an oral hypoglycemic agent (OHA) for type 2 diabetes treatment is associated with mortality in a national cohort. PROCEDURES: We prospectively followed Veterans Health Administration patients with type 2 diabetes initiating treatment with an OHA and not receiving any other diabetes pharmacotherapy for at least one year. Information on OHAs, weight, co-morbidities, other medications, demographics, and laboratory measurements was obtained from electronic medical records. Logistic regression was used to estimate 5-year mortality odds by weight change during the first year after OHA treatment initiation. FINDINGS:Patients (mean age 65years, 97% male, mean BMI 32.3kg/m2) initiating OHA monotherapy between 2003 and 2008 totaled 145,198 (metformin n=89,111, glipizide n=27,100, glyburide n=25,226, rosiglitazone n=3,761). Most patients (65%) maintained a stable weight (change ⩽5% from baseline) during the first year after OHA initiation. Those losing >5% of baseline weight had a significantly higher odds of death over the subsequent 5-years ranging from 1.64 to 2.13 depending on OHA type. In the metformin group, weight gain >5% of baseline was also associated with higher odds of 5-year mortality. The same results were obtained after conducting three sensitivity analyses that excluded patients for the following reasons: weight loss in the one year prior to OHA initiation, weight change >100lbs, or weight change >50lbs. CONCLUSIONS:Weight loss was associated with higher odds of 5-year mortality among patients initiating an OHA, as was weight gain for metformin only. Published by Elsevier B.V.
Authors: Mercedes R Carnethon; Peter John D De Chavez; Mary L Biggs; Cora E Lewis; James S Pankow; Alain G Bertoni; Sherita H Golden; Kiang Liu; Kenneth J Mukamal; Brenda Campbell-Jenkins; Alan R Dyer Journal: JAMA Date: 2012-08-08 Impact factor: 56.272
Authors: K Eeg-Olofsson; J Cederholm; P M Nilsson; B Zethelius; L Nunez; S Gudbjörnsdóttir; B Eliasson Journal: Diabetologia Date: 2008-11-05 Impact factor: 10.122
Authors: Chandra L Jackson; Hsin-Chieh Yeh; Moyses Szklo; Frank B Hu; Nae-Yuh Wang; Rosemary Dray-Spira; Frederick L Brancati Journal: J Gen Intern Med Date: 2013-08-09 Impact factor: 5.128