TOPLINE:

Among participants with type 2 diabetes (T2D) and obesity, achieving at least 15% weight loss within 2 years of a T2D diagnosis was associated with a 14% lower risk for macrovascular events and a 10% lower risk for microvascular events than maintaining a stable weight.

METHODOLOGY:

• Researchers conducted a cohort study using UK real-world data to evaluate whether achieving at least 15% weight loss within 2 years of a T2D diagnosis was associated with a lower risk of developing macrovascular and microvascular complications.
• Eligible individuals had obesity (BMI ≥ 30 to ≤ 60) measured within ± 6 months of T2D diagnosis and had at least one subsequent BMI measurement during a baseline window from at least 3 months to a maximum of 2 years after diagnosis, which was used to determine weight change.
• A total of 72,480 participants were included. Of these, 14,496 participants (mean age, 53.3 years; 46.1% men) who achieved at least 15% weight loss were matched to 57,984 control participants (mean age, 53.6 years; 49.3% men) who maintained a stable weight (< 2% change from BMI at diagnosis).
• Primary outcomes were the time to the first macrovascular event (myocardial infarction, stroke, angina, and peripheral arterial disease) and the first microvascular event (chronic kidney disease, retinopathy, and neuropathy).
• The mean duration of follow-up was 83.4 months for macrovascular outcomes and 82.8 months for microvascular outcomes.

TAKEAWAY:

• Participants in the weight-loss group had a 14% lower risk for first macrovascular events than those in the stable weight group (hazard ratio [HR], 0.86; 95% CI, 0.81-0.91).
• The weight-loss group also showed a 10% lower risk for first microvascular events than the stable weight group (HR, 0.90; 95% CI, 0.86-0.94).
• When individual outcomes were analysed, the weight-loss group showed significantly lower risks for myocardial infarction (HR, 0.83), angina (HR, 0.85), chronic kidney disease (HR, 0.91), and retinopathy (HR, 0.85).
• Within 1 year after achieving weight loss, a higher proportion of participants in the weight‑loss group vs the stable weight group achieved A1c levels ≤ 6.5% (78% vs 31%), normoglycaemia (33% vs 3%), and systolic blood pressure < 130 mm Hg (48% vs 32%), despite using fewer medications.

IN PRACTICE:

"When viewed alongside mechanistic, genetic, pharmacological, and broader epidemiological data, the findings reinforce large-scale early intentional weight reduction as a key therapeutic strategy associated with improvements in not only glycemic control but also long-term cardiovascular health in type 2 diabetes," the authors wrote.

SOURCE:

The study was led by Eva Johnsen, Novo Nordisk A/S, Copenhagen, Denmark. It was published online on June 08, 2026, in Diabetes Care.

LIMITATIONS:

Residual confounding could not be ruled out, and the study could not determine whether the weight loss was intentional. BMI was measured at irregular, clinically driven timepoints rather than at predefined intervals. Additionally, the analyses did not account for changes in medication use after the date a participant first met the weight‑loss criterion.

DISCLOSURES:

The study was funded by Novo Nordisk A/S. Six authors disclosed being employees of Novo Nordisk A/S, and five of them also reported being shareholders in the company. Some authors disclosed being shareholders or receiving consulting or speaker honoraria and/or grant support from multiple sources.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.