Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 Jul;42(7):3354-3368.
doi: 10.1007/s12325-025-03230-7. Epub 2025 May 19.

Glycaemic and Weight Control in People Aged 65 or Younger Newly Diagnosed with Type 2 Diabetes in Spain: Insights from the PRIORITY-T2D Study

Emilio Ortega  1   2   3 , Jennifer Redondo-Antón  4 , Silvia Díaz-Cerezo  4 , Miriam Rubio-de Santos  4 , Irene Romera  5
Affiliations
Observational Study

Glycaemic and Weight Control in People Aged 65 or Younger Newly Diagnosed with Type 2 Diabetes in Spain: Insights from the PRIORITY-T2D Study

Emilio Ortega et al. Adv Ther. 2025 Jul.

Abstract

Introduction: The objective of this study was to determine the number of people within glycated haemoglobin (HbA1c) targets and achieving weight-loss goals during the first 5 years after type 2 diabetes (T2D) diagnosis and to explore the relationship between early weight loss and glycaemic control in routine care in Spain.

Methods: This was an observational retrospective study using IQVIA's electronic medical record database, including adults aged ≤ 65 years newly diagnosed with T2D. Variables included baseline sociodemographic/clinical characteristics, yearly HbA1c and weight data, and treatment patterns. Descriptive statistics and regression analyses were used.

Results: A total of 8973 people with T2D were included (mean age 53 years; mean baseline HbA1c 7.7%; obesity at diagnosis: 64%). During the first 5 years post-T2D diagnosis, 46-63% of the population did not have HbA1c < 6.5%, and > 60%, and > 80% of subjects did not achieve ≥ 5% and ≥ 10% weight loss, respectively. Early weight loss goal achievement (1st year after diagnosis) and weight loss magnitude were associated with a higher percentage of people with HbA1c < 6.5%.

Conclusions: Many individuals with T2D did not have HbA1c < 6.5% in the first 5 years after diagnosis and did not achieve ≥ 5% or ≥ 10% weight loss. Early weight loss after T2D diagnosis was associated with higher likelihood of achieving early glycaemic control.

Keywords: Glycated haemoglobin; Health outcomes; Spain; Treatment patterns; Type 2 diabetes; Weight loss.

Plain language summary

This study looked at how many people with type 2 diabetes met blood glucose targets and weight-loss goals in the first 5 years after their diagnosis. It also explored the link between early weight loss and blood glucose control in regular healthcare settings in Spain. Researchers analysed data from electronic medical records, focussing on adults aged 65 or younger who were newly diagnosed with diabetes. The study looked at the characteristics of people with diabetes, yearly blood glucose levels (as reflected in their glycated haemoglobin levels), weight measurements, and treatment patterns. The study used statistical methods to summarise the data and find connections. The study included 8973 people with newly diagnosed type 2 diabetes, with an average age of 53 years and an average starting glycated haemoglobin of 7.7%. About 64% had obesity at diagnosis. Over the first 5 years, 46–63% of people did not achieve glycated haemoglobin levels below 6.5%. Guidelines recommend glycated haemoglobin levels equal or below 7.0%, or 6.5% for people who can achieve this goal safely. Additionally, more than 60% did not lose at least 5% of their weight, and more than 80% did not lose at least 10%. Those who lost weight within the first year after diagnosis and lost more weight overall were more likely to achieve good blood glucose control. This study concluded that many people with type 2 diabetes did not achieve their blood glucose or weight-loss goals within 5 years of diagnosis. However, losing a meaningful amount of weight early on was linked to better blood glucose control early in the disease.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflicts of Interest: Emilio Ortega has received institutional grants from Eli Lilly and Novo Nordisk, consulting fees from Eli Lilly, honoraria for presentations, manuscript writing or educational events from Eli Lilly and Novo Nordisk, and support for meeting attendance and/or travel from Eli Lilly and Novo Nordisk. Jennifer Redondo-Antón, Silvia Díaz-Cerezo, Miriam Rubio-de Santos, and Irene Romera are employees and minor shareholders of Eli Lilly and Company, Spain. Ethical Approval: As this was an observational study that used previously collected data and did not impose any form of intervention, and the data were previously deidentified/anonymised to protect participant privacy, a formal Consent to Release Information form was not required. Permission was obtained to access and use data from this database. The study protocol was approved by the ethical review board of Hospital Clinic (Barcelona, Spain) (approval code HCB/2023/0287, dated 16 May 2023), as required by Spanish regulations related to healthcare observational studies. The study was conducted in accordance with the ethical principles that have their origin in the Declaration of Helsinki and are consistent with Good Pharmacoepidemiology Practices and applicable laws and regulations of Spain.

Figures

Fig. 1
Fig. 1
Participant flow according to the study inclusion criteria. EMRs electronic medical records, HbA1c glycated haemoglobin, T2D type 2 diabetes
Fig. 2
Fig. 2
Percentage of people a within HbA1c targets, and b achieving weight loss goals. HbA1c glycated haemoglobin
Fig. 3
Fig. 3
Treatment patterns: a use of pharmacotherapy, combination therapy and high-efficacy drugs for glycaemic management, with high-efficacy drugs defined as high-dose dulaglutide, semaglutide and insulin, according to the 2022 ADA/EASD consensus report [1]; b use of pharmacotherapy according to weight-reducing efficacy, defined as per the 2022 ADA/EASD consensus report [1] and Galindo and colleagues [9]. The graph represents the sum of the percentage of people receiving the drugs that fall into the same category (weight-neutral, weight-inducing and weight-reducing), alone or in combination (fixed-dose combinations excluded), each year of analysis. Percentages do not add up to 100%, as patients could be receiving a combination of two or more agents. ADA American Diabetes Association, DPP4is dipeptidyl peptidase 4 inhibitors, EASD European Association for the Study of Diabetes, GLP-1 RAs glucagon-like peptide-1 receptor agonists, SGLT2is sodium glucose cotransporter 2 inhibitors
Fig. 4
Fig. 4
The relationship between early weight loss and HbA1c control (< 6.5%) by year of follow-up. HbA1c glycated haemoglobin
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Davies MJ, Aroda VR, Collins BS, et al. Management of hyperglycemia in type 2 diabetes: a consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45:2753–86. 10.2337/dci22-0034. - PMC - PubMed
    1. Samson SL, Vellanki P, Blonde L, et al. American Association of Clinical Endocrinology consensus statement: comprehensive type 2 diabetes management algorithm - 2023 Update. Endocr Pract. 2023;29:305–40. 10.1016/j.eprac.2023.02.001. - PubMed
    1. Laiteerapong N, Ham SA, Gao Y, et al. The legacy effect in type 2 diabetes: Impact of early glycemic control on future complications (the Diabetes & Aging Study). Diabetes Care. 2019;42:416–26. 10.2337/dc17-1144. - PMC - PubMed
    1. Laiteerapong N, Karter AJ, Moffet HH, et al. Ten-year hemoglobin A1c trajectories and outcomes in type 2 diabetes mellitus: The Diabetes & Aging Study. J Diabetes Complications. 2017;31:94–100. 10.1016/j.jdiacomp.2016.07.023. - PMC - PubMed
    1. American Diabetes Association Professional Practice Committee. 8. Obesity and weight management for the prevention and treatment of type 2 diabetes: Standards of care in diabetes—2024. Diabetes Care. 2024;47(Suppl 1):S145–57. 10.2337/dc23-S008. - PMC - PubMed

Publication types