Related Experiment Video
Updated: Jun 16, 2026

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Trajectories of BMI Before Diagnosis of Type 2 Diabetes: The Rotterdam Study
Jana Nano1,2,3, Klodian Dhana4, Eralda Asllanaj1,5
1Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Objective:
People with diabetes show great variability in weight gain and duration of obesity at the time of diagnosis. BMI trajectories and other cardiometabolic risk factors prior to type 2 diabetes were investigated.
Methods:
A total of 6,223 participants from the Rotterdam Study cohort were included. BMI patterns before diagnosis of diabetes were identified through latent class trajectories.
Results:
During a mean follow-up of 13.7 years, 565 participants developed type 2 diabetes. Three distinct trajectories of BMI were identified, including the "progressive overweight" group (n = 481, 85.1%), "progressive weight loss" group (n = 59, 10.4%), and "persistently high BMI" group (n = 25, 4.4%). The majority, the progressive overweight group, was characterized by a steady increase of BMI in the overweight range 10 years before diabetes diagnosis. The progressive weight loss group had fluctuations of glucose and marked beta cell function loss. The persistently high BMI group was characterized by a slight increase in insulin levels and sharp increase of insulin resistance accompanied by a rapid decrease of beta cell function.
Conclusions:
Heterogeneity of BMI changes prior to type 2 diabetes was found in a middle-aged and elderly white population. Prevention strategies should be tailored rather than focusing only on high-risk individuals.
Related Concept Videos
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Type II Diabetes I: Introduction
Type II Diabetes II: Pathophysiology
Diabetes Mellitus: Type 2 and Gestational
Carbohydrate Metabolism
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in the...
Diabetes: Symptoms, Diagnosis, and Complications

