Impact of weight gain on the evolution and regression of prediabetes: a quantitative analysis

The quantitative impact of weight gain on prediabetic glucose dysregulation remains unknown; only one study quantitated the impact of weight loss. We quantified the impact of weight gain on the evolution and regression of prediabetes (PDM).

In 4234 subjects without diabetes, using logistic regression analysis with a 4.8-year follow-up period, we analyzed the relationship between (1) δBMI (BMI_{follow-up-basal}) and the progression from normal glucose regulation (NGR) to PDM or diabetes, and (2) δBMI and the regression from PDM to NGR.

Mean (±s.d.) δBMI was 0.17 (±1.3) kg/m² in subjects with NGR and δBMI was positively and independently related to progression (adjusted odds ratio (OR_adj) (95% CI), 1.24 (1.15-1.34), P<0.01). Mean (±s.d.) δBMI was -0.03 (±1.25) kg/m² in those with PDM and δBMI was negatively related to the regression (OR_adj, 0.72 (0.65-0.80), P<0.01). The relation of δBMI to the progression was significant in men (OR_adj, 1.42 (1.28-1.59), P<0.01) but not in women (OR_adj, 1.05 (0.94-1.19), P=0.36). Also, the negative impact of δBMI on the regression was significant only in men (men, OR_adj, 0.65 (0.57-0.75), P<0.01; women, OR_adj, 0.94 (0.77-1.14), P=0.51).

In Japanese adults, an increase in the BMI by even 1 kg/m² was related to 24% increase in the risk of development of PDM or diabetes in NGR subjects and was related to 28% reduction in the regression from PDM to NGR. In women, we did not note any significant impact of weight gain on the evolution or regression of PDM.