BMI trajectories and their relation to medication, comorbidities, and healthcare service use among people with type 2 diabetes mellitus

23/08/2026

AI Summary

Three distinct BMI trajectories after T2D diagnosis: stable (77.7%), increasing (14.6%), and decreasing (7.7%).
Decreasing class showed lowest HbA1c and LDL measurement activity; GLP-1 receptor agonist use peaked in decreasing (2015) then increasing (2024).
Increasing class accumulated kidney, obesity related, sleep and lower respiratory diseases; decreasing class had more dementia, cardiovascular disease and highest healthcare utilisation.

AI Summary

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.

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.

Basic summary

Diabetes Res Clin Pract. 2026 Aug 22:113515. doi: 10.1016/j.diabres.2026.113515. Online ahead of print.

ABSTRACT

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.

PMID:42632459 | DOI:10.1016/j.diabres.2026.113515

Document this CPD