Obesity, weight loss and prognosis in type 2 diabetes
Lean, M.E.; Powrie, J.K.; Anderson, A.S.; Garthwaite, P.H.
Diabetic Medicine a Journal of the British Diabetic Association 7(3): 228-233
1990
ISSN/ISBN: 0742-3071 PMID: 2139394 Document Number: 353845
Medical records were reviewed of all 263 type 2 diabetic patients from the Aberdeen diabetic clinic known to have died in 1985 or 1986. Mean age was 65 years at diagnosis and 72 and 75 years at death for men and women, respectively. Life expectancy at age 65 was 35% less than published figures for the general population. Analysis of survival in 233 patients who lived more than 1 year (189 overweight) using stepwise multiple regression indicated as significant adverse independent variable age, presence of clinical ischaemic heart disease and plasma glucose at diagnosis, and as significant favourable variables: oral hypoglycaemic drug therapy, weight loss in the first year and an interaction between weight loss and body mass index (BMI) for patients with BMI greater than 25 kg/msuperscript 2. Changes in therapy over the years are likely to have biased these results towards including oral hypoglycaemic therapy and excluding the expected adverse effect of smoking. Mean weight loss at 1 year was 2.6 kg for those with BMI 25 to 30 and 6.8 kg with BMI greater than 30 kg/msuperscript 2, following standard diabetic advice. For the average patient each 1 kg weight loss was associated with 3 to 4 months prolonged survival.