Aims/Hypothesis: This study aimed to investigate the impact of weight changes on the clinical outcomes of diabetic nephropathy and retinopathy among patients with newly diagnosed diabetes.

Methods: Using nationally representative data from the Korean National Health Insurance System, 181,872 patients newly diagnosed with diabetes who were free of end-stage renal disease (ESRD) and proliferative diabetic retinopathy (PDR) during 2007-2012 were followed to the end of 2016. Weight change was defined as the difference in body weight from the time of diabetes diagnosis to 2 years later.

Results: There were 180 cases of ESRD (0.10%) and 780 cases of PDR (0.43%) followed-up for a median of 5.5 years from the index year at 2 years after diagnosis. Those with moderate weight gain (+5% to +10%) showed a significantly higher hazard ratio (HR) for ESRD, compared with those with modest weight changes (−5% to +5%) after adjusting for several confounding factors, including the baseline estimated glomerular filtration rate (HR, 1.732; 95% CI 1.125-2.667). Those with severe weight loss (−5% to −10%) showed the lowest HR for PDR (HR, 0.591; 95% CI 0.372-0.938), whereas those with severe weight gain (> +10%) showed the highest HR for PDR (HR, 1.732; 95% CI 1.125-2.667).

Conclusion: This study provides direct evidence that a change in body weight affects the risk of diabetic microvascular complications. Strategies to control body weight may reduce the risk of ESRD and PDR in patients with newly diagnosed diabetes.


H. Kwon: None. K. Song: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at