Body weight course in the DIAbetes and LifEstyle Cohort Twente (DIALECT-1)—A 20-year observational study

Christina M. Gant, Ijmke Mensink, S. Heleen Binnenmars, Job A.M. van der Palen, Stephan J.L. Bakker, Gerjan Navis, Gozewijn D. Laverman

Research output: Contribution to journalArticleAcademicpeer-review

12 Downloads (Pure)

Abstract

Background Although weight gain increases risk of type 2 diabetes, real-life data on the weight course in patients with established type 2 diabetes are scarce. We assessed weight course in a real-life diabetes secondary care setting and analyzed its association with patient characteristics, lifestyle habits and initiation of insulin, glucagon like peptide-1 receptor agonists (GLP-1 RA) and sodium-glucose co-transporter-2 inhibitors (SGLT-2i). Methods Data on weight, insulin, GLP-1 RA and SGLT-2i use were collected retrospectively (12 years) and prospectively (8 years) from patients included in the DIAbetes and LifEstyle Cohort Twente-1 (DIALECT-1, n = 450, age 63 ± 9 years, 58% men, diabetes duration [7–18] years). Lifestyle habits were assessed using validated questionnaires. The association of clinical parameters with body mass index (BMI) course was determined using linear mixed models. Patients who underwent bariatric surgery (n = 19) had a distinct BMI course and were excluded from the study. Results Baseline BMI was 31.3 (0.3) and was higher in women, patients aged <60 years and patients with unfavorable lifestyle habits. BMI increased to 32.5 (0.3) after 12 years (P<0.001), and thereafter decreased to 31.5 (0.3) after 20 years, resulting in a similar BMI as the baseline BMI (P = 0.96, compared to baseline). Clinical parameters or initiation of insulin or SGLT-2i were not associated with BMI course. Patients who initiated GLP-1 RA declined in BMI compared to non-users (Pinteraction = 0.003). Conclusions High BMI that real-life patients with type 2 diabetes gained earlier in life, remained stable in the following decades. Weight loss interventions should remain a priority, and GLP-1 RA might be considered to support weight loss.

Original languageEnglish
Article numbere0218400
JournalPLoS ONE
Volume14
Issue number6
DOIs
Publication statusPublished - 19 Jun 2019

Fingerprint

observational studies
Medical problems
lifestyle
Observational Studies
body mass index
diabetes
Life Style
Body Mass Index
Body Weight
Symporters
body weight
Sodium-Glucose Transporter 2
symporters
agonists
Sodium
Insulin
noninsulin-dependent diabetes mellitus
Glucose
Type 2 Diabetes Mellitus
Habits

Cite this

Gant, C. M., Mensink, I., Binnenmars, S. H., van der Palen, J. A. M., Bakker, S. J. L., Navis, G., & Laverman, G. D. (2019). Body weight course in the DIAbetes and LifEstyle Cohort Twente (DIALECT-1)—A 20-year observational study. PLoS ONE, 14(6), [e0218400]. https://doi.org/10.1371/journal.pone.0218400
Gant, Christina M. ; Mensink, Ijmke ; Binnenmars, S. Heleen ; van der Palen, Job A.M. ; Bakker, Stephan J.L. ; Navis, Gerjan ; Laverman, Gozewijn D. / Body weight course in the DIAbetes and LifEstyle Cohort Twente (DIALECT-1)—A 20-year observational study. In: PLoS ONE. 2019 ; Vol. 14, No. 6.
@article{eb4080d833ca40829a5ce6a04392948c,
title = "Body weight course in the DIAbetes and LifEstyle Cohort Twente (DIALECT-1)—A 20-year observational study",
abstract = "Background Although weight gain increases risk of type 2 diabetes, real-life data on the weight course in patients with established type 2 diabetes are scarce. We assessed weight course in a real-life diabetes secondary care setting and analyzed its association with patient characteristics, lifestyle habits and initiation of insulin, glucagon like peptide-1 receptor agonists (GLP-1 RA) and sodium-glucose co-transporter-2 inhibitors (SGLT-2i). Methods Data on weight, insulin, GLP-1 RA and SGLT-2i use were collected retrospectively (12 years) and prospectively (8 years) from patients included in the DIAbetes and LifEstyle Cohort Twente-1 (DIALECT-1, n = 450, age 63 ± 9 years, 58{\%} men, diabetes duration [7–18] years). Lifestyle habits were assessed using validated questionnaires. The association of clinical parameters with body mass index (BMI) course was determined using linear mixed models. Patients who underwent bariatric surgery (n = 19) had a distinct BMI course and were excluded from the study. Results Baseline BMI was 31.3 (0.3) and was higher in women, patients aged <60 years and patients with unfavorable lifestyle habits. BMI increased to 32.5 (0.3) after 12 years (P<0.001), and thereafter decreased to 31.5 (0.3) after 20 years, resulting in a similar BMI as the baseline BMI (P = 0.96, compared to baseline). Clinical parameters or initiation of insulin or SGLT-2i were not associated with BMI course. Patients who initiated GLP-1 RA declined in BMI compared to non-users (Pinteraction = 0.003). Conclusions High BMI that real-life patients with type 2 diabetes gained earlier in life, remained stable in the following decades. Weight loss interventions should remain a priority, and GLP-1 RA might be considered to support weight loss.",
author = "Gant, {Christina M.} and Ijmke Mensink and Binnenmars, {S. Heleen} and {van der Palen}, {Job A.M.} and Bakker, {Stephan J.L.} and Gerjan Navis and Laverman, {Gozewijn D.}",
year = "2019",
month = "6",
day = "19",
doi = "10.1371/journal.pone.0218400",
language = "English",
volume = "14",
journal = "PLoS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "6",

}

Body weight course in the DIAbetes and LifEstyle Cohort Twente (DIALECT-1)—A 20-year observational study. / Gant, Christina M.; Mensink, Ijmke; Binnenmars, S. Heleen ; van der Palen, Job A.M.; Bakker, Stephan J.L.; Navis, Gerjan; Laverman, Gozewijn D.

In: PLoS ONE, Vol. 14, No. 6, e0218400, 19.06.2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Body weight course in the DIAbetes and LifEstyle Cohort Twente (DIALECT-1)—A 20-year observational study

AU - Gant, Christina M.

AU - Mensink, Ijmke

AU - Binnenmars, S. Heleen

AU - van der Palen, Job A.M.

AU - Bakker, Stephan J.L.

AU - Navis, Gerjan

AU - Laverman, Gozewijn D.

PY - 2019/6/19

Y1 - 2019/6/19

N2 - Background Although weight gain increases risk of type 2 diabetes, real-life data on the weight course in patients with established type 2 diabetes are scarce. We assessed weight course in a real-life diabetes secondary care setting and analyzed its association with patient characteristics, lifestyle habits and initiation of insulin, glucagon like peptide-1 receptor agonists (GLP-1 RA) and sodium-glucose co-transporter-2 inhibitors (SGLT-2i). Methods Data on weight, insulin, GLP-1 RA and SGLT-2i use were collected retrospectively (12 years) and prospectively (8 years) from patients included in the DIAbetes and LifEstyle Cohort Twente-1 (DIALECT-1, n = 450, age 63 ± 9 years, 58% men, diabetes duration [7–18] years). Lifestyle habits were assessed using validated questionnaires. The association of clinical parameters with body mass index (BMI) course was determined using linear mixed models. Patients who underwent bariatric surgery (n = 19) had a distinct BMI course and were excluded from the study. Results Baseline BMI was 31.3 (0.3) and was higher in women, patients aged <60 years and patients with unfavorable lifestyle habits. BMI increased to 32.5 (0.3) after 12 years (P<0.001), and thereafter decreased to 31.5 (0.3) after 20 years, resulting in a similar BMI as the baseline BMI (P = 0.96, compared to baseline). Clinical parameters or initiation of insulin or SGLT-2i were not associated with BMI course. Patients who initiated GLP-1 RA declined in BMI compared to non-users (Pinteraction = 0.003). Conclusions High BMI that real-life patients with type 2 diabetes gained earlier in life, remained stable in the following decades. Weight loss interventions should remain a priority, and GLP-1 RA might be considered to support weight loss.

AB - Background Although weight gain increases risk of type 2 diabetes, real-life data on the weight course in patients with established type 2 diabetes are scarce. We assessed weight course in a real-life diabetes secondary care setting and analyzed its association with patient characteristics, lifestyle habits and initiation of insulin, glucagon like peptide-1 receptor agonists (GLP-1 RA) and sodium-glucose co-transporter-2 inhibitors (SGLT-2i). Methods Data on weight, insulin, GLP-1 RA and SGLT-2i use were collected retrospectively (12 years) and prospectively (8 years) from patients included in the DIAbetes and LifEstyle Cohort Twente-1 (DIALECT-1, n = 450, age 63 ± 9 years, 58% men, diabetes duration [7–18] years). Lifestyle habits were assessed using validated questionnaires. The association of clinical parameters with body mass index (BMI) course was determined using linear mixed models. Patients who underwent bariatric surgery (n = 19) had a distinct BMI course and were excluded from the study. Results Baseline BMI was 31.3 (0.3) and was higher in women, patients aged <60 years and patients with unfavorable lifestyle habits. BMI increased to 32.5 (0.3) after 12 years (P<0.001), and thereafter decreased to 31.5 (0.3) after 20 years, resulting in a similar BMI as the baseline BMI (P = 0.96, compared to baseline). Clinical parameters or initiation of insulin or SGLT-2i were not associated with BMI course. Patients who initiated GLP-1 RA declined in BMI compared to non-users (Pinteraction = 0.003). Conclusions High BMI that real-life patients with type 2 diabetes gained earlier in life, remained stable in the following decades. Weight loss interventions should remain a priority, and GLP-1 RA might be considered to support weight loss.

UR - http://www.scopus.com/inward/record.url?scp=85067481884&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0218400

DO - 10.1371/journal.pone.0218400

M3 - Article

VL - 14

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 6

M1 - e0218400

ER -