| Summary: | 碩士 === 國立成功大學 === 老年學研究所 === 101 === Objective: Little is known about weight changes preceding diagnosis of diabetes in middle-aged and older adults. We examine long-term trajectories in body mass index (BMI) of those who do and do not develop diabetes. Study Design and Setting: This study utilized retrospective cohort study design with participants aged 50+ from the Taiwan Longitudinal Study of Aging (TLSA, 1989-2007). Individuals who developed diabetes in 2007 (n=200) were compared to adults without diabetes throughout the observational period (n=3,576). Multilevel modeling was used to examine annual levels and rates of change in BMI before diabetes. Results: We found an overall trend of increasing BMI (βtime=0.08, p〈.001), and the trend slowed as the participants aged (βtime2= -0.002, p〈.001). Participants who developed diabetes exhibit higher BMI scores (βdiabetes =1.294, p〈.01) and a faster rate of weight gain (βdiabetes*time=0.15, p〈0.05) until approximately 6.5 years before physician-diagnosed diabetes. Diabetes associated with the higher level of BMI was especially evident in women; and the faster rate of weight gain was especially prominent in men or individuals with BMI≥24. These results has controlled for time-varying comorbidities and behavioral factors. Conclusions: Our study support that diabetes is associated with a faster rate of weight gain, even in middle-aged and older adults. The finding that middle-aged and older adults who develop diabetes experience an unplanned weight loss prior to self-reported diagnosis has practical implications that unplanned weight loss may be an alarm for under-diagnosed diabetes or a precursor to developing diabetes.
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