Adults with type 2 diabetes are at high risk for developing heart disease, which is the most common and costly diabetes complication. Weight loss among newly diagnosed diabetes patients may lead to normalisation of blood sugar levels without medications and may reduce risk of future cardiovascular disease, cancer, and premature mortality. The longer that weight loss is maintained over time may further reduce risk of these events, and weight loss occurring earlier during diabetes disease progression may be more beneficial than weight loss occurring later on. However, there is a lack of research to assess the impact of weight loss on risk of chronic diseases, and research in this area is necessary to inform interventions aimed at reducing diabetes complications such as heart attack or stroke among people with diabetes. Our research objective is to determine patterns of changes in weight following diabetes diagnosis and assess whether these changes in weight impact whether a person develops heart disease or other diabetes complications.
Cardiovascular complications account for the majority of diabetes treatment costs globally. Weight loss following diabetes diagnosis improves cardiovascular risk factors and may lead to diabetes remission and reduction in incidence of cardiovascular disease (CVD) events, cancer, and premature mortality. Results of intensive behavioural intervention trials have shown long-term CVD benefits of large weight losses, however weight loss achieved in these trials may not be achievable in the absence of an intensive intervention, and trial cohorts may not be generalizable to broader patient populations. Furthermore, the timing of weight loss in the diabetes disease trajectory and the duration that weight loss is sustained may affect CVD risk, though this has not been assessed. Although weight management is likely among the most effective methods to reduce diabetes complications at the population level, there are currently no existing policies for interventions focused on weight management in primary care. There is a need for research to identify effective weight loss targets to inform such interventions. Therefore, we aim to characterize weight change trajectories following diabetes diagnosis and determine to what extent weight loss, and distinct weight change patterns, may impact long-term health outcomes among adults with diabetes. We will use latent class analysis to identify patterns of weight change, and will then use Cox proportional hazards regression to estimate hazard ratios of the associations of weight change patterns and 10-year incidence of CVD, other diabetes complications, cancer, and all-cause mortality.
Cardiovascular disease (PRIMARY), all-cause mortality (PRIMARY), cancer incidence (SECONDARY)
Jean Strelitz - Chief Investigator - University of Cambridge
Jean Strelitz - Corresponding Applicant - University of Cambridge
Amy Ahern - Collaborator - University of Cambridge
Evangelos Kontopantelis - Collaborator - University of Manchester
Nazrul Islam - Collaborator - University of Cambridge
Patricia Eustachio Colombo - Collaborator - University of Cambridge
Salwa Zghebi - Collaborator - University of Manchester
Simon Griffin - Collaborator - University of Cambridge
HES Admitted Patient Care;NCRAS Cancer Registration Data;ONS Death Registration Data;Patient Level Index of Multiple Deprivation