Sm. Shoff et al., WEIGHT CHANGE AND GLYCEMIC CONTROL IN A POPULATION-BASED SAMPLE OF ADULTS WITH OLDER-ONSET DIABETES, The journals of gerontology. Series A, Biological sciences and medical sciences, 53(1), 1998, pp. 27-32
Background. Numerous clinic-based studies have observed improved glyce
mic control with even moderate weight reductions, for periods up to 1
year, in obese subjects with noninsulin-dependent diabetes mellitus (N
IDDM). Similar benefits of weight loss have not been well documented i
n free-living populations, particularly in older persons with NIDDM of
long duration. Methods, Relations between weight change and glycosyla
ted hemoglobin were evaluated in a population-based sample of persons
with older-onset diabetes. Persons participating in baseline (1980-198
2, n = 1370) and two followup examinations (1984-1986, n = 987; 1990-1
992, n = 550) were included. Mean glycosylated hemoglobin levels among
those losing, gaining, or remaining within 5 kg were compared in all
subjects combined and stratified by insulin use, using ordinary least-
squares regression to adjust for confounding variables. Results, Subje
cts who lost weight had higher mean glycosylated hemoglobin compared t
o those who gained weight (baseline to second exam only). This pattern
remained in those not using insulin. Weight change was not related to
glycosylated hemoglobin in persons using insulin. Conclusions, Associ
ations suggest that in older persons not using insulin, moderate weigh
t loss over periods of 4-6 years has little beneficial impact on glyco
sylated hemoglobin. Weight loss may be reflecting disease processes th
at also result in poor glycemic control. Intentional weight loss achie
ved over a shorter time period and maintained through the later years
in older diabetic persons remains to be evaluated.