Fluctuating Body Weight May Increase Kidney Disease Risk in Type 1 Diabetes

Body weight cycling, the repeated loss and regain of body weight, has been linked to several adverse health outcomes. A recent retrospective analysis by Marion Camoin, MD, and colleagues from the Assistance Publique-Hôpitaux de Paris investigated its impact on renal function in patients with type 1 diabetes. The study utilized data from the Diabetes Control and Complications Trial (DCCT) and the Epidemiology of Diabetes Interventions and Complications (EDIC) studies to examine this association (1^✔ ✔Trusted Source
Body-weight Cycling and Risk of Diabetic Kidney Disease in People With Type 1 Diabetes in the DCCT/EDIC Population

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Association Between Body Weight Variability and Renal Decline

The study included 1432 participants from the DCCT/EDIC cohort and assessed intra-individual body weight variability using four indices, with variability independent of the mean (VIM) serving as the primary index. The follow-up period lasted approximately 21 years, during which six criteria for chronic kidney disease (CKD) progression were analyzed.

Key Findings

The analysis revealed a significant association between high VIM and key indicators of renal decline, including:

• A 40% reduction in estimated glomerular filtration rate (eGFR) from baseline values.
• Doubling of baseline serum creatinine levels.
• Progression to CKD stage 3.
• An annual decline in eGFR of more than 3 mL/min/m².

After adjusting for CKD risk factors and nephroprotective drug use, the association remained significant. While VIM was initially linked to increased albuminuria, further adjustment for follow-up covariates rendered this association statistically insignificant. Similar findings were observed across other body weight cycling indices.

Implications for Diabetes Management

These findings suggest that frequent fluctuations in body weight may contribute to renal complications in individuals with type 1 diabetes. Maintaining a stable body weight could be crucial in preserving kidney function and mitigating CKD risk.

Given these findings, healthcare providers should emphasize sustainable weight management strategies for patients with type 1 diabetes. Strategies should include:

• Encouraging gradual, long-term weight maintenance rather than repeated cycles of weight loss and regain.
• Monitoring kidney function closely in individuals with a history of weight cycling.
• Educating patients on the potential renal risks associated with body weight variability.

The study highlights the potential dangers of body weight cycling in individuals with type 1 diabetes, particularly concerning kidney health. Long-term weight stability may play a vital role in preventing CKD progression and improving overall health outcomes in this population. Further research is necessary to develop targeted interventions that promote consistent weight management in diabetes care.

Reference:

1. Body-weight Cycling and Risk of Diabetic Kidney Disease in People With Type 1 Diabetes in the DCCT/EDIC Population - (https://pubmed.ncbi.nlm.nih.gov/39902910/)

Source-Medindia