In a nutshell
This study investigated whether type 2 diabetes patients were at increased risk of weight gain when starting insulin treatment. Weight gain differed depending on the patient’s weight when starting insulin treatment.
Some background
Type 2 diabetes is a progressive disease where the cells in the pancreas that produce insulin, called beta cells, are destroyed the longer a person has the disease. Many patients will eventually need insulin treatment to manage their condition. Many patients do not want to begin insulin treatment because they are worried they will gain weight. This is an even bigger concern for patients who are already overweight or obese. There is currently no information on the level of weight gain from due to insulin based on the patient’s weight prior to the start of treatment.
Methods & findings
This study looked at changes in patients’ body weight for two years after starting insulin treatment. HbA1c levels (a measure of average blood glucose levels over the past 3 months) relative to the weight change were also analyzed.
155,917 people took part in the study. They were categorized based on their body mass index (BMI, measure of body fat that takes height and weight into account): normal weight (BMI less than 25 kg/m2), overweight (BMI 25-30 kg/m2), grade 1 obese (BMI 30-35 kg/m2), grade 2 obese (BMI 35-40 kg/m2), and grade 3 obese (BMI greater than 45 kg/m2).
Normal and overweight patients continuously gained weight from 6 months to 2 years (between 2 kg and 4 kg). Overweight, grade 1, and grade 2 obese patients showed average weight gains of 0.9 kg after 1 year. Grade 3 obese patients showed average weight loss of 1.1 kg after 1 year, and 2.2 kg after 2 years.
Control of blood sugars with insulin was similar among patients. In grade 3 obese patients, a 1% HbA1c reduction was not associated with any increase in weight.
The bottom line
The study concluded that weight gain associated with insulin treatment is much lower in obese patients with type 2 diabetes than in normal weight or overweight patients. The level of HbA1c reached over the two years was similar in all weight groups. Grade 3 obese patients can achieve a 1% reduction in HbA1c control with no increase in weight.
The fine print
Information on medication adherence, and diet and exercise, was incomplete.
What’s next?
If you are considering insulin treatment, you can discuss these results with your doctor.
Published By :
Diabetes, Obesity and Metabolism
Date :
Aug 09, 2016
