Trial reportThe Journal of clinical endocrinology and metabolism2020
The Risks of Cardiovascular Disease and Mortality Following Weight Change in Adults with Diabetes: Results from ADVANCE.
Trial report in The Journal of clinical endocrinology and metabolism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association of magnitude of weight loss and weight variability with mortality and major cardiovascular events among individuals with type 2 diabetes mellitus: a systematic review and meta-analysis.Cardiovascular diabetology · 2022Pooled it
- Retinal BioAge is associated with indicators of cardiovascular-kidney-metabolic syndrome in UK and US populations.Scientific reports · 2026Article
- Successful large caloric deficit with high protein modification diet and intensive aerobic and resistance training with progressive overload in adult patient with significant coronary artery disease: a case report.Frontiers in cardiovascular medicine · 2026Article
- Associations Between Body Mass Index Trajectories and Healthcare Utilization and Costs Among Patients with Type 2 Diabetes in Finland.Clinical epidemiology · 2026Article
- The Obesity Paradox of Cardiovascular Outcomes in Patients with Diabetes Mellitus.Current diabetes reports · 2025Review
- Weight change and the risk of cardiovascular disease in patients with hypertension: A primary-care cohort study.Journal of global health · 2024Article
- Body weight, weight change and the risk of cardiovascular disease in patients with hypertension: a primary-care cohort study.International journal of obesity (2005) · 2023Article
- Comparison of gliclazideWorld journal of diabetes · 2022Article
- Weight Change Since Age 20 and the Risk of Cardiovascular Disease Mortality: A Prospective Cohort Study.Journal of atherosclerosis and thrombosis · 2022Article
- Abdominal volume index trajectories and risk of diabetes mellitus: Results from the China Health and Nutrition Survey.Journal of diabetes investigation · 2022Article
- Weight Change, Lifestyle, and Mortality in Patients With Type 2 Diabetes.The Journal of clinical endocrinology and metabolism · 2022Observational
- Physical performance and glycemic control under SGLT-2-inhibitors in patients with type 2 diabetes and established atherosclerotic cardiovascular diseases or high cardiovascular risk (PUSH): Design of a 4-week prospective observational study.Frontiers in cardiovascular medicine · 2022Article
- The importance of weight stabilization amongst those with overweight or obesity: Results from a large health care system.Preventive medicine reports · 2021Article
- Weight change and risk of cardiovascular disease among adults with type 2 diabetes: more than 14 years of follow-up in the Tehran Lipid and Glucose Study.Cardiovascular diabetology · 2021Observational
- Long-Term Weight Change and Glycemic Control in Patients With Type 2 Diabetes Mellitus and Treated vs. Untreated Sleep-Disordered Breathing-Analysis From the DIAbetes COhoRtE.Frontiers in neurology · 2021Article
- Review
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
contextWeight loss is strongly recommended for overweight and obese adults with type 2 diabetes. Unintentional weight loss is associated with increased risk of all-cause mortality, but few studies have examined its association with cardiovascular outcomes in patients with diabetes.
objectiveTo evaluate 2-year weight change and subsequent risk of cardiovascular events and mortality in established type 2 diabetes. DESIGN AND
settingThe Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation was an international, multisite 2×2 factorial trial of intensive glucose control and blood pressure control. We examined 5 categories of 2-year weight change: >10% loss, 4% to 10% loss, stable (±<4%), 4% to 10% gain, and >10% gain. We used Cox regression with follow-up time starting at 2 years, adjusting for intervention arm, demographics, cardiovascular risk factors, and diabetes medication use from the 2-year visit.
resultsAmong 10 081 participants with valid weight measurements, average age was 66 years. By the 2-year examination, 4.3% had >10% weight loss, 18.4% had 4% to 10% weight loss, and 5.3% had >10% weight gain. Over the following 3 years of the trial, >10% weight loss was strongly associated with major macrovascular events (hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.26-2.44), cardiovascular mortality (HR, 2.76; 95% CI, 1.87-4.09), all-cause mortality (HR, 2.79; 95% CI, 2.10-3.71), but not major microvascular events (HR, 0.91; 95% CI, 0.61-1.36), compared with stable weight. There was no evidence of effect modification by baseline body mass index, age, or type of diabetes medication.
conclusionsIn the absence of substantial lifestyle changes, weight loss may be a warning sign of poor health meriting further workup in patients with type 2 diabetes.
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