{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:37:56Z","timestamp":1787503076648,"version":"build-2736575974"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T00:00:00Z","timestamp":1720137600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T00:00:00Z","timestamp":1720137600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Innovative Medicines Initiative 2 Joint Undertaking","award":["875534"],"award-info":[{"award-number":["875534"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Diabetologia"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims\/hypothesis<\/jats:title>\n                    <jats:p>Few studies have examined the clinical characteristics associated with changes in weight before and after diagnosis of type 2 diabetes. Using a large real-world cohort, we derived trajectories of BMI before and after diabetes diagnosis, and examined the clinical characteristics associated with these trajectories, including assessing the impact of pre-diagnosis weight change on post-diagnosis weight change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed an observational cohort study using electronic medical records from individuals in the Scottish Care Information Diabetes Collaboration database. Two trajectories were calculated, based on observed BMI measurements between 3 years and 6 months before diagnosis and between 1 and 5 years after diagnosis. In the post-diagnosis trajectory, each BMI measurement was time-dependently adjusted for the effects of diabetes medications and HbA\n                      <jats:sub>1c<\/jats:sub>\n                      change.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2736 individuals were included in the study. There was a pattern of pre-diagnosis weight gain, with 1944 individuals (71%) gaining weight overall, and 875 (32%) gaining more than 0.5 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      per year. This was followed by a pattern of weight loss after diagnosis, with 1722 individuals (63%) losing weight. Younger age and greater social deprivation were associated with increased weight gain before diagnosis. Pre-diagnosis weight change was unrelated to post-diagnosis weight change, but post-diagnosis weight loss was associated with older age, female sex, higher BMI, higher HbA\n                      <jats:sub>1c<\/jats:sub>\n                      and weight gain during the peri-diagnosis period. When considering the peri-diagnostic period (defined as from 6 months before to 12 months after diagnosis), we identified 986 (36%) individuals who had a high HbA\n                      <jats:sub>1c<\/jats:sub>\n                      at diagnosis but who lost weight rapidly and were most aggressively treated at 1 year; this subgroup had the best glycaemic control at 5 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\/interpretation<\/jats:title>\n                    <jats:p>\n                      Average weight increases before diagnosis and decreases after diagnosis; however, there were significant differences across the population in terms of weight changes. Younger individuals gained weight pre-diagnosis, but, in older individuals, type 2 diabetes is less associated with weight gain, consistent with other drivers for diabetes aetiology in older adults. We have identified a substantial group of individuals who have a rapid deterioration in glycaemic control, together with weight loss, around the time of diagnosis, and who subsequently stabilise, suggesting that a high HbA\n                      <jats:sub>1c<\/jats:sub>\n                      at diagnosis is not inevitably associated with a poor outcome and may be driven by reversible glucose toxicity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00125-024-06217-1","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T00:01:47Z","timestamp":1720137707000},"page":"2236-2245","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Trajectories of BMI before and after diagnosis of type 2 diabetes in a real-world population"],"prefix":"10.1007","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4902-1040","authenticated-orcid":false,"given":"Louise A.","family":"Donnelly","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3957-1981","authenticated-orcid":false,"given":"Rory J.","family":"McCrimmon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9237-8585","authenticated-orcid":false,"given":"Ewan R.","family":"Pearson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,5]]},"reference":[{"issue":"7","key":"6217_CR1","doi-asserted-by":"publisher","first-page":"e1002086","DOI":"10.1371\/journal.pmed.1002086","volume":"13","author":"K Dhana","year":"2016","unstructured":"Dhana K, Nano J, Ligthart S et al (2016) Obesity and life expectancy with and without diabetes in adults aged 55 years and older in the Netherlands: a prospective cohort study. 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SOPHIA has received funding from the Innovative Medicines Initiative\u00a02 Joint Undertaking under grant agreement number 875534. This Joint Undertaking receives support from the European Union\u2019s Horizon 2020 research and innovation programme, the EFPIA and T1D Exchange, JDRF and the Obesity Action Coalition. The communication reflects the authors\u2019 views and neither the IMI nor the European Union, EFPIA or any associated partners are responsible for any use that may be made of the information contained herein.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"ERP has received payment or honoraria for lectures, presentations, speakers\u2019 bureaus, manuscript writing or educational events from Eli Lilly, Illumina and Sanofi, and support for attending meetings and\/or travel from Eli Lilly. RJM has received honoraria for lectures and advisory boards for NovoNordisk and Sanofi. The authors declare that there are no other relationships or activities that might bias, or be perceived to bias, their work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 relationships and activities"}},{"value":"LAD designed the study and performed the analyses. All authors contributed to data interpretation and drafting of the manuscript. All authors critically revised the manuscript and approved the final version. ERP is the guarantor of this work.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}