Association between weight loss and HbA1c management in patients with diabetes: a NHANES analysis

Abstract Background Research suggests that weight loss may enhance glycemic control in patients with diabetes. A recent 5-year cohort study in the UK further substantiated this assertion by highlighting the significant correlation between weight reduction and improved HbA1c management. However, furt...

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Main Authors: Zheng Zhang, Peng Gu, Genshan Li, Wenqi Du
Format: Article
Language:English
Published: SpringerOpen 2025-05-01
Series:The Egyptian Journal of Internal Medicine
Subjects:
Online Access:https://doi.org/10.1186/s43162-025-00440-x
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author Zheng Zhang
Peng Gu
Genshan Li
Wenqi Du
author_facet Zheng Zhang
Peng Gu
Genshan Li
Wenqi Du
author_sort Zheng Zhang
collection DOAJ
description Abstract Background Research suggests that weight loss may enhance glycemic control in patients with diabetes. A recent 5-year cohort study in the UK further substantiated this assertion by highlighting the significant correlation between weight reduction and improved HbA1c management. However, further research is necessary to ascertain the universality of this finding for populations not subjected to interventions and across diverse clinical settings. Moreover, the interplay between the levels of physical activity and the concentrations of glycated hemoglobin merits further exploration. Methods This retrospective cohort study used the NHANES database and included patients aged 21 years or older who had been diagnosed with diabetes for 1 year or older, were not using insulin, and had experienced weight loss. Patients were classified on the basis of percentage of weight loss in the prior year (< 5% vs. ≥ 5%) and HbA1c levels (≥ 6.5% vs. < 6.5%). Results The percentage of weight loss was significantly correlated with HbA1c levels (≥ 6.5% vs. < 6.5%), as demonstrated by the weighted generalized linear model (OR = 1.569; 95% CI = 1.027–2.396, p < 0.05). After adjusting for the percentage of weight loss or proportional weight loss (Box-Cox) and other covariates, vigorous physical activity levels exhibited a negative effect on blood glucose control. The results of the subgroup analysis indicated a positive correlation between proportional weight loss and HbA1c levels (≥ 6.5% vs. < 6.5%) in unmarried individuals who are non-Hispanic Black or of other races and do not consume alcohol or use oral antidiabetic medications. The restricted cubic spline plot did not reveal any significant nonlinear relationships. Conclusions Weight loss surpassing 5% was positively correlated with enhanced HbA1c regulation (HbA1c < 6.5%). Intense physical activity may be inappropriate for individuals with diabetes.
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spelling doaj-art-068e05cf8e404c68ae5c1c1b0b3ee9a72025-08-20T03:54:00ZengSpringerOpenThe Egyptian Journal of Internal Medicine2090-90982025-05-0137111110.1186/s43162-025-00440-xAssociation between weight loss and HbA1c management in patients with diabetes: a NHANES analysisZheng Zhang0Peng Gu1Genshan Li2Wenqi Du3Qinghai University School of MedicineClinical Medical School, Qinghai UniversityQinghai University School of MedicineQinghai University School of MedicineAbstract Background Research suggests that weight loss may enhance glycemic control in patients with diabetes. A recent 5-year cohort study in the UK further substantiated this assertion by highlighting the significant correlation between weight reduction and improved HbA1c management. However, further research is necessary to ascertain the universality of this finding for populations not subjected to interventions and across diverse clinical settings. Moreover, the interplay between the levels of physical activity and the concentrations of glycated hemoglobin merits further exploration. Methods This retrospective cohort study used the NHANES database and included patients aged 21 years or older who had been diagnosed with diabetes for 1 year or older, were not using insulin, and had experienced weight loss. Patients were classified on the basis of percentage of weight loss in the prior year (< 5% vs. ≥ 5%) and HbA1c levels (≥ 6.5% vs. < 6.5%). Results The percentage of weight loss was significantly correlated with HbA1c levels (≥ 6.5% vs. < 6.5%), as demonstrated by the weighted generalized linear model (OR = 1.569; 95% CI = 1.027–2.396, p < 0.05). After adjusting for the percentage of weight loss or proportional weight loss (Box-Cox) and other covariates, vigorous physical activity levels exhibited a negative effect on blood glucose control. The results of the subgroup analysis indicated a positive correlation between proportional weight loss and HbA1c levels (≥ 6.5% vs. < 6.5%) in unmarried individuals who are non-Hispanic Black or of other races and do not consume alcohol or use oral antidiabetic medications. The restricted cubic spline plot did not reveal any significant nonlinear relationships. Conclusions Weight loss surpassing 5% was positively correlated with enhanced HbA1c regulation (HbA1c < 6.5%). Intense physical activity may be inappropriate for individuals with diabetes.https://doi.org/10.1186/s43162-025-00440-xDiabetesHbA1cWeight lossNHANES
spellingShingle Zheng Zhang
Peng Gu
Genshan Li
Wenqi Du
Association between weight loss and HbA1c management in patients with diabetes: a NHANES analysis
The Egyptian Journal of Internal Medicine
Diabetes
HbA1c
Weight loss
NHANES
title Association between weight loss and HbA1c management in patients with diabetes: a NHANES analysis
title_full Association between weight loss and HbA1c management in patients with diabetes: a NHANES analysis
title_fullStr Association between weight loss and HbA1c management in patients with diabetes: a NHANES analysis
title_full_unstemmed Association between weight loss and HbA1c management in patients with diabetes: a NHANES analysis
title_short Association between weight loss and HbA1c management in patients with diabetes: a NHANES analysis
title_sort association between weight loss and hba1c management in patients with diabetes a nhanes analysis
topic Diabetes
HbA1c
Weight loss
NHANES
url https://doi.org/10.1186/s43162-025-00440-x
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