Obesity precedes the development of type 2 diabetes (T2D). However, the relationship between the magnitude and rate of weight gain to T2D development and complications, especially in non-White populations, has received less attention.
We determined the association of rate and magnitude of weight gain to age at T2D diagnosis (Age T2D), HbA1c at T2D diagnosis (HbA1c T2D), microalbuminuria, and diabetic retinopathy after adjusting for sex, BMI at age 20 years, lifestyles, family history of T2D and/or blood pressure and lipids in 2164 Korean subjects aged ≥30 years and newly diagnosed with diabetes. Body weight at age 20 years (Wt 20y) was obtained by recall or from participants’ medical, school, or military records. Participants recalled their maximum weight (Wt max) prior to T2D diagnosis and age at maximum weight (Age max_wt). The rate of weight gain (Rate max_wt) was calculated from magnitude of weight gain (ΔWt = Wt max–Wt 20y) divided by ΔTime (Age max_wt –20 years). The mean Age max_wt and Age T2D were 41.5±10.9 years and 50.1±10.5 years, respectively. The Wt 20y and Wt max were 59.9±10.5 kg and 72.9±11.4 kg, respectively. The Rate max_wt was 0.56±0.50 kg/year. After adjusting for risk factors, greater ΔWt and higher Rate max_wt were significantly associated with earlier Age T2D, higher HbA1c T2D after additional adjusting for Age T2D, and microalbuminuria after further adjusting for HbA1c T2D and lipid profiles. Greater ΔWt and higher Rate max_wt were also significantly associated with diabetic retinopathy.