A new long-term study has revealed that body-weight cycling, commonly known as yo-yo dieting, poses significant risks to kidney health in individuals with type 1 diabetes, independent of other traditional risk factors.
The research, published in The Journal of Clinical Endocrinology & Metabolism, analyzed data from 1,432 participants in the Diabetes Control and Complications Trial (DCCT) and its follow-up study, tracking outcomes over a mean period of 21 years.
Key Findings on Kidney Function Decline
The study identified several concerning patterns of kidney damage associated with weight cycling. Approximately 19% of participants experienced a 40% decline in estimated glomerular filtration rate (eGFR), with an incidence rate of 9.2 per 1000 person-years. Statistical models showed that weight cycling increased this risk by 16% to 26%.
More alarming was the impact on serum creatinine levels, where 8.6% of participants experienced a doubling of baseline values. The risk increase associated with weight cycling ranged from 25% to 35% for this outcome, suggesting a substantial impact on kidney function.
Progression to Chronic Kidney Disease
The investigation revealed that 8.9% of participants progressed to stage 3 chronic kidney disease (CKD). Weight cycling was associated with a 21% to 36% increased risk of developing this condition. Additionally, 7.1% of participants showed rapid kidney function decline, defined as an eGFR slope steeper than -3 mL/min/1.73 m2 per year.
Impact on Albuminuria
The study also examined the relationship between weight cycling and albuminuria:
- 26% of participants developed moderately increased albuminuria
- 11.7% progressed to severely increased albuminuria
- Risk increases ranged from 3% to 18% for moderate albuminuria
- Severe albuminuria risk increased by up to 36% in some cases
Mechanisms and Clinical Implications
The researchers noted that insulin therapy might play a crucial role in driving body weight cycling due to its anabolic effects. The complex interplay between genetic, environmental, and pharmacological factors contributes to weight fluctuations in type 1 diabetes patients.
"The causes of weight cycling can be multiple and complex," the study authors explained, highlighting the need for further research into the underlying pathophysiological mechanisms.
Clinical Recommendations
The findings emphasize the importance of stable weight management in type 1 diabetes care. Healthcare providers should focus on developing strategies that promote long-term weight maintenance rather than short-term weight loss solutions. This approach may help improve overall health outcomes and reduce the risk of kidney complications in patients with type 1 diabetes.
