Obesity, weight loss and prognosis in type 2 diabetes
Abstract
Medical records were reviewed of all 263 Type 2 diabetic patients from the Aberdeen diabetic clinic who were known to have died in 1985 or 1986. Mean age was 65 years (interquartile range 57-75 years) at diagnosis and 72 (66-80) years for men, 75 (72-83) years for women, at death. Life expectancy at age 65 was 35% less than published figures for the general population. Analysis of survival in 233 patients who lived more than 1 year (189 overweight) using stepwise multiple regression indicated as significant (p less than 0.05) adverse independent variables: age at diagnosis, presence of clinical ischaemic heart disease at diagnosis, plasma glucose at diagnosis; and as significant favourable variables: oral hypoglycaemic drug therapy, weight loss in the first year, and an interaction between weight loss and BMI for patients with BMI greater than 25 kg m-2. Changes in fashions over the years are likely to have biased these results towards including oral hypoglycaemic therapy and excluding the expected adverse effect of smoking. Mean weight loss at 1 year was 2.6 kg for those with BMI 25-30 kg m-2, 6.8 kg with BMI greater than 30 kg m-2, following standard dietetic advice. For the average patient each 1 kg weight loss was associated with 3-4 months prolonged survival.
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A cohort study using standard dietetic advice to produce intentional weight loss in older adults with type 2 diabetes demonstrated that every 1 kg of weight loss was associated with 3-4 months survival prolongation.
“Conversely, a cohort study using standard dietetic advice to produce intentional weight loss in older adults with T2D demonstrated that every 1 kg of weight loss was an associated 3–4 months survival prolongation [64]”
From Obesity pharmacotherapy in older adults: a narrative review of evidence (2025) · cites this paper as [64]
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- Authors
- Lean, M. E. J., Powrie, J. K., Anderson, A. S., & Garthwaite, P. H.
- Affiliations
- Aberdeen Royal Infirmary (GB)
- University of Aberdeen (GB)
- Corresponding author
- Lean, M.E.J.
- ORCID
- Anderson, A.S.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 1990-03-04
- Volume
- 7
- Issue
- 3
- Pages
- 228-233
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W1966031472
- Cited by
- 318
- References
- 10
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 7 · 2023: 6 · 2022: 8 · 2021: 3 · 2020: 9 · 2019: 6 · 2018: 7 · 2017: 9 · 2016: 10 · 2015: 4 · 2014: 10 · 2013: 9 · 2012: 7
- FWCI
- 1.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (publishedVersion)
- Open Research Online (The Open University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, obesity, weight loss, survival, prognosis, body mass index, oral antidiabetic drugs, ischemic heart disease, age at diagnosis, plasma glucose, smoking
- MeSH terms
- Aged, Body Weight, Diabetes Mellitus, Diabetes Mellitus, Type 2, Diet, Diabetic, Female, Humans, Life Expectancy, Male, Obesity, Prognosis, Retrospective Studies, Smoking, Weight Loss, Body Mass Index
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