Diabetes research and clinical practice · 2026
BMI trajectories and their relation to medication, comorbidities, and healthcare service use among people with type 2 diabetes mellitus.
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Koivunen Suvi, Lamidi Marja-Leena, Wang Zhiting, Lavikainen Piia, Wikström Katja, Storvik Suchetana De, Kivinen Petri, Rautiainen Päivi, Laatikainen Tiina
Аннотация
AIMS: To identify BMI trajectories after type 2 diabetes (T2D) diagnosis and examine associations with laboratory measures, medication use, comorbidities, and healthcare utilization.
METHODS: We analyzed BMI trajectories in 3,539 adults with T2D in North Karelia (2011-2014) and followed until 2024. BMI trajectory classes were estimated using growth mixture modeling. Regression models were used to assess differences in measurement activity, treatment intensity and diabetes medication use between the classes.
RESULTS: Three BMI trajectories were identified: stable (77.7 %), increasing (14.6 %), and decreasing (7.7 %). HbA1c and LDL cholesterol measurement activity was lowest in the decreasing class. Use of glucagon-like peptide-1 agonists varied over time, peaking in the decreasing class in 2015 and in the increasing class in 2024. Comorbidities increased in all classes but differed in pattern: the increasing class accumulated more chronic kidney and urinary tract diseases, obesity related diagnoses, sleep disorders, and chronic lower respiratory diseases, whereas the decreasing class had higher prevalence of dementia and cardiovascular and pulmonary diseases. Healthcare utilization was highest in the decreasing class.
CONCLUSIONS: These findings reveal considerable heterogeneity in long-term outcomes among people with T2D and highlight the need for continuous monitoring and targeted support to maintain metabolic control and manage comorbidity burden.
METHODS: We analyzed BMI trajectories in 3,539 adults with T2D in North Karelia (2011-2014) and followed until 2024. BMI trajectory classes were estimated using growth mixture modeling. Regression models were used to assess differences in measurement activity, treatment intensity and diabetes medication use between the classes.
RESULTS: Three BMI trajectories were identified: stable (77.7 %), increasing (14.6 %), and decreasing (7.7 %). HbA1c and LDL cholesterol measurement activity was lowest in the decreasing class. Use of glucagon-like peptide-1 agonists varied over time, peaking in the decreasing class in 2015 and in the increasing class in 2024. Comorbidities increased in all classes but differed in pattern: the increasing class accumulated more chronic kidney and urinary tract diseases, obesity related diagnoses, sleep disorders, and chronic lower respiratory diseases, whereas the decreasing class had higher prevalence of dementia and cardiovascular and pulmonary diseases. Healthcare utilization was highest in the decreasing class.
CONCLUSIONS: These findings reveal considerable heterogeneity in long-term outcomes among people with T2D and highlight the need for continuous monitoring and targeted support to maintain metabolic control and manage comorbidity burden.