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Impact of body weight on antidiabetic treatment and predictors of weight control under real-world conditions: a 2-year follow-up of DiaRegis cohort

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Abstract

Aims

Treatment strategies for obese patients with type 2 diabetes mellitus aim to increase physical activity, reduce body weight, and improve glucose control using weight-beneficial antidiabetic drugs. The objective of this study was to determine whether these strategies are implemented, and to identify factors predictive of glucose control and body weight management in a large, real-world patient population.

Methods

The prospective DiaRegis cohort study included 3807 patients with type 2 diabetes in whom the treating physician decided to intensify and optimize treatment because of insufficient glucose control.

Results

Antidiabetic treatment of overweight and obese patients was compared with that of normal-weight patients over a 2-years follow-up period, and multivariate analyses were performed to identify predictors of body weight loss. Among the 3807 participants, 92.5 % were overweight or obese. Normal-weight participants were more often treated with sulfonylureas or insulin, and overweight and obese patients with metformin or glucagon-like peptide (GLP)-1 analogues. Predictors of weight loss were body mass index (BMI) ≥30 kg/m2 and any reported physical activity.

Conclusions

DiaRegis study shows that under real-world conditions, antidiabetic drug therapy is performed dependent on body weight. This strategy results in adequate glucose control and moderate weight reductions in overweight and obese patients. Weight loss is affected by treatment with weight-beneficial drugs, but also by any reported physical activity. However, only a small subgroup of patients perform physical activity. Initiation and maintenance of a physically active lifestyle remains a significant challenge for physicians, and patients with type 2 diabetes.

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Acknowledgments

We wish to acknowledge the excellent support of Mirjam Strasser and Caroline Sickora (representative of the Winicker Norimed GmbH) and Sonja Frey, Benjamin Weidig and Thomas Riemer (representative of the Stiftung Institut für Herzinfarktforschung) during the preparation and the conduct of the registry. In addition, we wish to acknowledge the support of all participating physicians and patients without whom the present registry would have not been possible.

Funding

Bristol-Myers Squibb, AstraZeneca.

Author information

Authors and Affiliations

  1. Department of Gastroenterology and Diabetology, Klinikum Ludwigshafen, Bremserstraße 79, 67063, Ludwigshafen, Germany

    B. Hartmann

  2. Institute for Pharmacology and Preventive Medicine, Mahlow, Germany

    P. Bramlage

  3. Stiftung Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany

    S. Schneider & A. K. Gitt

  4. Herz- und Diabeteszentrum Nordrhein-Westfalen in Bad Oeynhausen, Universitätsklinik der Ruhr Universität Bochum, Bochum, Germany

    D. Tschöpe

  5. Stiftung “Der herzkranke Diabetiker” in der Deutschen Diabetes Stiftung, Bad Oeynhausen, Germany

    D. Tschöpe

  6. Department of Cardiology, Herzzentrum Ludwigshafen, Klinikum Ludwigshafen, Ludwigshafen, Germany

    A. K. Gitt

Authors
  1. B. Hartmann
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  2. P. Bramlage
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  3. S. Schneider
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Corresponding author

Correspondence to B. Hartmann.

Ethics declarations

Conflict of interest

Diethelm Tschöpe (DT), Peter Bramlage (PB), and Anselm K. Gitt (AKG) have received research support and honoraria for lectures from Bristol-Myers Squibb and AstraZeneca, the sponsors of the present registry. Steffen Schneider (StS) and Bettina Hartmann (BH) have no competing interest to disclose.

Ethical standard

The registry was conducted in accordance with Good Epidemiology Practice and applicable regulatory requirements. The registry protocol was approved by the ethics committee of the Landesärztekammer Thüringen in Jena, Germany, on March 4, 2009.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Patients being enrolled into this registry provided written informed consent.

Additional information

Managed by Massimo Federici.

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Hartmann, B., Bramlage, P., Schneider, S. et al. Impact of body weight on antidiabetic treatment and predictors of weight control under real-world conditions: a 2-year follow-up of DiaRegis cohort. Acta Diabetol 52, 1093–1101 (2015). https://doi.org/10.1007/s00592-015-0794-0

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  • DOI: https://doi.org/10.1007/s00592-015-0794-0

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