TOPLINE:

A study of Japanese adults showed that a weight increase of at least 1% in 1 year was associated with a 15%-51% higher risk for type 2 diabetes (T2D) than having a stable weight. In contrast, a weight reduction of at least 1% in 1 year was associated with a 16%-26% lower risk for the condition. These associations persisted in individuals with a BMI ≥ 25 and in those who had gained 10 kg or more since the age of 20.

METHODOLOGY:

• Although many studies have examined the effect of weight reduction on glycemic control in people with overweight or obesity, few have investigated the relationship between weight gain and the risk for T2D, especially in individuals without obesity.
• Researchers investigated the association between weight change and the risk of developing T2D in individuals without the condition using a large medical database in Japan; 41,539 patients without diabetes (mean age, 64.6 years; 40.7% men; mean BMI, 22.9) who underwent health examinations between April 2013 and March 2015 were included.
• The onset of diabetes was defined as A1c levels ≥ 48 mmol/mol (6.5%), fasting plasma glucose levels ≥ 126 mg/dL, or the initiation of antihyperglycemic therapy.
• The association between the weight change over 1 year and the risk of developing T2D was assessed over a mean follow-up duration of 5.7 years.

TAKEAWAY:

• During the follow-up, 3564 cases of new-onset T2D were reported.
• Compared with participants who maintained a stable body weight (< 1.0% change), those with weight decreases of 1.0%-2.9%, 3.0%-4.9%, and ≥ 5.0% showed a lower risk for T2D (hazard ratios [HRs], 0.84, 0.75, and 0.74, respectively; P < .001 for all).
• In contrast, weight increases of 1.0%-2.9%, 3.0%-4.9%, and ≥ 5.0% were associated with a higher risk for T2D (HRs, 1.15, 1.35, and 1.51, respectively; P < .01 for all).
• The positive association between an increase in weight and the risk for T2D persisted among individuals with a BMI of 22-25 and ≥ 25 and in those who had gained more than 10 kg since the age of 20. No association was seen in those with a BMI < 22.
• When stratified by age group, the positive association persisted among participants younger than 65 years and those aged 65-74 years but not for those aged 75 years or older.

IN PRACTICE:

“Preventing weight gain, in addition to reducing weight, is important for the prevention of type 2 diabetes in Japanese individuals, particularly among those with BMI ≥ 22,” the authors wrote.

SOURCE:

This study was led by Takuya Kagisaki, MD, Department of Metabolic Medicine, Graduate School of Medicine, The University of Osaka, Suita, Japan. It was published online in The Journal of Clinical Endocrinology & Metabolism.

LIMITATIONS:

The generalizability of findings might be limited as the study data came from health examinations of individuals older than 40 years, who were primarily self-employed or nonregular employees living in rural areas. Information on physical activity, walking speed, dietary habits, and weight change from age 20 was based on self-reported questionnaires, which may contain measurement errors. Additionally, factors such as muscle mass and socioeconomic status were not fully accounted for, and weight changes were assessed over only 1 year.

DISCLOSURES:

This study received support from the Japan Agency for Medical Research and Development. One author disclosed being a member of the Department of Lifestyle Medicine and served as an editorial board member for The Journal of Clinical Endocrinology & Metabolism.

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