← Insulin × glycemic control

TrialThe Journal of clinical endocrinology and metabolism2022

Weight Loss, Lifestyle Intervention, and Metformin Affect Longitudinal Relationship of Insulin Secretion and Sensitivity.

Elsa Vazquez Arreola et al.PubMed ↗Full text ↗Publisher ↗

  • Weight loss (per 5 kg)cuts both waysLower secretory demand, higher compensatory insulin secretion, lower diabetes risk.Correlation only, not a test of it.
  • Increasing compensatory insulin secretion (per baseline SD)looks good hereLower diabetes risk.Correlation only, not a test of it.

What moved togetherboth groups pooled, not the treatment’s effect

Correlation, not cause

Weight loss (per 5 kg) went with lower secretory demand

−0.14−0.16 to −0.13

weight loss (per 5 kg) vs no weight loss / baseline

As reported

difference −0.144, 95% CI −0.16 to −0.13

Correlation, not cause

Weight loss (per 5 kg) went with higher compensatory insulin secretion

+0.29+0.26 to +0.31

weight loss (per 5 kg) vs no weight loss / baseline

As reported

difference 0.287, 95% CI 0.26–0.31

Correlation, not cause

Increasing compensatory insulin secretion (per baseline SD) went with lower diabetes risk

−83%−87% to −79%

increasing compensatory insulin secretion (per baseline SD) vs lower compensatory insulin secretion

Bigger than 9 in 10 for glycemic control

As reported

HR 0.166, 95% CI 0.13–0.21

+1 more in the walkthrough ↓

Who was studied, and how

2,931people with type 2 diabetes, in this paper

Already taking weight loss (per 5 kg), or nottheir own situation, not assigned

on weight loss (per 5 kg)
not on weight loss / baseline

Weight loss (per 5 kg) went with lower secretory demand−0.14

Weight loss (per 5 kg) went with higher compensatory insulin secretion+0.29

Weight loss (per 5 kg) went with lower diabetes risk−29%

correlation, not a test

Already taking increasing compensatory insulin secretion (per baseline SD), or nottheir own situation, not assigned

on increasing compensatory insulin secretion (per baseline SD)
lower compensatory insulin secretion

Increasing compensatory insulin secretion (per baseline SD) went with lower diabetes risk−83%

correlation, not a test

the abstract, start to end

… reduced secretory demand (b=-0.144 SD; 95% CI (-0.162, -0.125)/5 kg loss) and increased compensatory insulin secretion (b = 0.287 SD, 95% CI (0.261, 0.314)/5 kg …

… insulin secretion (hazard ratio [HR] = 0.166 per baseline SD, 95% CI 0.133, 0.206) and weight loss (HR = 0.710 per 5 kg loss, 95% CI 0.613, …

← favours treatmentfavours comparator →
could be chance
Secretory demandweight loss (per 5 kg) vs no weight loss / baseline
−0.144−0.16 to −0.13
Compensatory insulin secretionweight loss (per 5 kg) vs no weight loss / baseline
0.2870.26–0.31
Diabetes riskincreasing compensatory insulin secretion (per baseline SD) vs lower compensatory insulin secretion
HR 0.1660.13–0.21
Diabetes riskweight loss (per 5 kg) vs no weight loss / baseline
HR 0.7100.61–0.82
InsulinGlycemic controlBody weight & composition
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Full record →Abstract, authors, funding and every citing paper · PMID 36062951