Weight loss in T2D patients ups death risk, but lifestyle change can help

Mortality is heightened among type 2 diabetes (T2D) patients with substantial weight loss, but such risk can be attenuated by improving lifestyle quality, suggests a recent study.

In this prospective analysis, the authors examined 11,262 incident T2D patients from the Nurses’ Health Study and the Health Professionals Follow-up Study. They evaluated weight change bracketing T2D diagnosis with regard to mortality, as well as analysed the potential effect modification by a healthy lifestyle consisting of high-quality diet, regular physical activity, nonsmoking status, and moderate alcohol consumption.

Patients with T2D lost an average of 2.3 kg during a 2-year time window spanning the T2D diagnosis. Body weight increased afterwards following a trajectory similar to that of nondiabetic individuals. Those who lost at least 10 percent of body weight had a 21-percent increased risk of all-cause mortality (95 percent confidence interval [CI], 9‒35) compared with patients with a stable weight.

Lifestyle significantly dictated the trajectory of these associations: the hazard ratios of all-cause mortality when comparing ≥10-percent weight loss with stable weight were 1.63 (95 percent CI, 1.26‒2.09) among participants with a deteriorated lifestyle, 1.27 (95 percent CI, 1.11‒1.46) for a stable lifestyle, and 1.02 (95 percent CI, 0.81‒1.27) for an improved lifestyle (p_interaction<0.001).

Major weight loss also appeared to increase cause-specific mortality. Likewise, lifestyle modifications showed a similar effect on this association.

“These results highlight the role of adopting a healthy lifestyle for newly diagnosed T2D patients, especially among those who might lose weight unintentionally, and improving long-term survival,” the authors said.