High body weight variability predicts the development of cardiovascular complications in type 2 diabetes !!!

Key Points
• Conclusion: “High body weight variability predicts the development of cardiovascular complications in type 2 diabetes. These data suggest that any strategy to reduce the body weight in these subjects should be aimed at maintaining the reduction in the long-term, avoiding oscillations.”
• In this population-based study, Swedish researchers examined the relationship between body weight variability (BWV) and the risk of cardiovascular complications in patients with type 2 diabetes without cardiovascular disease. Body weight was measured over 3 years, with variability expressed in quartiles. The primary outcome was a composite of non-fatal myocardial infarction, non-fatal stroke, and all-cause mortality and was analyzed during five years following the first 3 years of exposure to weight variability.
• Risk of the primary outcome increased with increased body weight variability, after compensating for known cardiovascular risk factors. Additionally, body weight variability was linked to non-fatal myocardial infarction, non-fatal stroke, all-cause mortality, peripheral arterial disease, peripheral vascular angioplasty, hospitalization for heart failure, foot ulcer, and all-cause mortality.
• “ Insulin, glitazons, and sulphonylureas are known to promote weight gain, while metformin and the more recently introduced sodium-glucose transporters 2 inhibitors and glucagon-like receptor 1 agonists are held to produce a durable, albeit small, weight loss,” the authors wrote. “The findings of our study might support the use of the latter drugs, already prioritized in patients with cardiovascular diseases, in obese patients with T2D, since the reduction of BWV, among other risk factors and mechanisms, may help to minimize the cardiovascular risk of such population.”
• Strengths of the current study include its large sample size and long follow-up, as well as the inclusion of people without heart disease. Limitations include the impossibility of determining a causal link between body weight variability and cardiovascular complications, as well as determining an underlying mechanism.
Discussion question: What other factors increase the risk of cardiovascular disease in patients with type 2 diabetes?
Discussion question: What involuntary factors can contribute to body weight variability in patients with type 2 diabetes?