Weight Fluctuations May Increase Cardiovascular Risk in Individuals With Type 2 Diabetes

Weight fluctuations can lead to dangerous health outcomes, which include an elevated risk of heart failure and cardiovascular death, according to a study published in Cardiovascular Diabetology. Individuals with type 2 diabetes or those with higher cardiovascular disease risk may benefit from weight management strategies and frequent monitoring, the report suggests.

Researchers examined associations between extreme weight fluctuations and cardiovascular outcomes in 2 large randomized studies. The team included individuals from the Canagliflozin Cardiovascular Assessment Study (CANVAS; ClinicalTrials.gov Identifier: NCT02065791; n=8656) and Evaluation of the Effects of Canagliflozin on Renal and Cardiovascular Outcomes in Participants With Diabetic Nephropathy (CREDENCE; ClinicalTrials.gov Identifier: NCT02065791; n=3799) study with available weight data at 52 and 78 weeks.

The median weight gain was 4.5 kg (9.9 lbs) among the top 10% of individuals experiencing the most gain and median weight loss was 8.5 kg (18.7 lbs) among the top 10% of individuals experiencing the most weight loss. Treatment with canagliflozin only marginally affected weight increases, according to the report.

Multivariate assessment of the CANVAS report showed that individuals in the 10% for weight loss or gain demonstrated a higher risk for hHF (hazard ratio [HR], 1.61; 95% CI, 1.20-2.16) and cardiovascular death (HR, 1.53; 95% CI, 1.14-2.03). These results were comparable among individuals experiencing the greatest weight gain in the CREDENCE study compared with individuals who did not experience weight fluctuations (adjusted HR for hHV/ CV death, 1.62; 95% CI, 1.19-2.16).

“Extremes of weight gain or loss were independently associated with an excess of hHF and cardiovascular death,” according to the researchers. “This suggests that, in patients with [type 2 diabetes] and high cardiovascular risk, large changes in body weight should be carefully assessed in view of individualized management.”

Study limitations include an inability to obtain adiposity measures and failure to account for potential confounders.