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a MedStar
Research Institute, 108 Irving Street, NW, Washington, DC 20010, USA, b Center for Health Outcomes
and Evaluation, Plymouth, MI, USA, c Institute of Gerontology, Department of Internal
Medicine, Division of Geriatric Medicine, University of Michigan, and
VA Medical Center, Ann Arbor, MI, USA, d Department
of Biostatistics, School of Public Health, University of Michigan, Ann
Arbor, MI, USA
Correspondence to: Dr Resnick (her1{at}mhg.edu)
Accepted for publication 13 March 2000
STUDY
OBJECTIVE
To determine whether long term weight
gain and weight loss are associated with subsequent risk of type 2 diabetes in overweight, non-diabetic adults.
DESIGNProspective
cohort. Baseline overweight was defined as BMI
27.3 for women and
BMI27.8 for men. Annual weight change (kg/year) over 10 years was
calculated using measured weight at subjects' baseline and first
follow up examinations. In the 10 years after measurement of weight
change, incident cases of diabetes were ascertained by self report,
hospital discharge records, and death certificates.
SETTINGCommunity.
PARTICIPANTS1929
overweight, non-diabetic adults.
MAIN RESULTSIncident
diabetes was ascertained in 251 subjects. Age adjusted cumulative
incidence increased from 9.6% for BMI<29 to 26.2% for BMI37.
Annual weight change over 10 years was higher in subjects who become
diabetic compared with those who did not for all BMI<35. Relative to
overweight people with stable weight, each kg of weight gained annually
over 10 years was associated with a 49% increase in risk of developing
diabetes in the subsequent 10 years. Each kg of weight lost annually
over 10 years was associated with a 33% lower risk of diabetes in the
subsequent 10 years.
CONCLUSIONSWeight
gain was associated with substantially increased risk of diabetes among
overweight adults, and even modest weight loss was associated with
significantly reduced diabetes risk. Minor weight reductions may have
major beneficial effects on subsequent diabetes risk in overweight
adults at high risk of developing diabetes.
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