PDB72 The Impact on Utilities of Weight Loss and Weight Gain Among Canadian Patients With Type 2 Diabetes

Abstract

There is evidence in the literature linking weight gain on anti-diabetic medication to impact on psychosocial well-being and non-compliance in type 2 diabetes (T2D). Due to the lack of data on the impact of weight loss and the imminent introduction of a new class of oral agents (SGLT2 inhibitors) with demonstrated weight-loss properties, this study was designed to compare the impact of weight gain and weight loss on utilities among Canadian T2D patients. Health states included a T2D base-case health state and six additional weight change health states (base-case ±3%, ±5%, and ±7% weight change relative to current weight). Utilities were elicited using time trade-off techniques. Enrollment requirements included: having T2D for at least two years, adequate control on antidiabetic medication, not receiving insulin, and not enrolled in a T2D clinical trial. Among 96 respondents (mean age 55 years; 51% male; mean body mass index (BMI) 32 kg/m2) 84% expressed a desire to lose weight. The mean utility (standard error (SE)) for the base-case T2D health state was 0.911 (0.013). The utility decreased to 0.907 (0.013), 0.865 (0.014) and 0.806 (0.017) for the 3%, 5% and 7% weight gain health states, respectively, and increased to 0.923 (0.012), 0.940 (0.011) and 0.949 (0.010) for the 3%, 5% and 7% weight loss health states, respectively. Linear mixed models indicated that a change in weight leading to a one unit increase and decrease in BMI had significant effects (SE) on utilities of -0.0472 (0.005) and 0.0171 (0.003), respectively. We observed a dose-response relationship between weight change and patient-elicited utilities in T2D health states with weight gain having a stronger effect than weight loss. The weight-loss properties of SGLT2 inhibitors may improve utilities while preventing the disutility associated with weight gain, which may positively impact treatment compliance and health outcomes.