Factors Predictive of Weight Gain and Implications for Modeling in Type 2 Diabetes Patients Initiating Metformin and Sulfonylurea Combination Therapy

• Published in: Diabetes therapy 2015-12, Vol.6 (4), p.495-507
• Main Authors: Gordon, Jason P., Evans, Marc, Puelles, Jorge, McEwan, Philip C.
• Format: Article
• Language: English
• Subjects: Cardiology; Diabetes; Drug therapy; Endocrinology; Internal Medicine; Medicine; Medicine & Public Health; Obesity; Original Research; Risk factors
• ISSN: 1869-6953; 1869-6961
• DOI: 10.1007/s13300-015-0134-y

Introduction The objectives of this study were to (a) assess the factors associated with weight gain in a population of type 2 diabetes patients escalating from metformin (M) to M+ sulfonylurea (M + S) and (b) evaluate whether healthcare resource utilization associated with being overweight or obese is underestimated in typical health economic evaluations. Methods The study was a retrospective cohort study using UK Clinical Practice Research Datalink linked to Hospital Episode Statistics (CPRD/HES) data. The association between baseline phenotypic factors and weight gain was assessed using logistic regression. Hospitalization incidence rates per 1000 person-years for major diabetes-related complications according to body mass index (BMI) at baseline were estimated from the data (observed) and compared to those obtained from a validated diabetes model (predicted). Results 11,071 patients were included in the analysis; approximately 40% gained weight in the first year following escalation to M + S. Baseline age, HbA1c and gender were found to be predictors of weight gain [odds ratios 0.99 (1-year increment), 1.11 (1% increment) and 0.81 (female vs male), respectively, p