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[Mechanisms for weight gain during blood glucose normalization].
1Service d'Endocrinologie, Diabétologie, Nutrition Hôpital Edouard Herriot, Lyon.
Diabetes & Metabolism
|August 17, 2000
Summary
Insulin therapy for type 2 diabetes can cause weight gain due to reduced calorie loss and increased fat and muscle mass. Despite this, insulin effectively prevents microangiopathy without raising cardiovascular risks.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Pharmacology
Context:
- Type 2 diabetes often requires insulin therapy after oral medications fail.
- Insulin therapy is associated with significant weight gain in these patients.
- Understanding the mechanisms of insulin-induced weight gain is crucial for patient management.
Purpose:
- To elucidate the mechanisms behind weight gain during insulin therapy in type 2 diabetes.
- To analyze the body composition changes associated with insulin treatment.
- To evaluate the long-term impact of insulin therapy on microangiopathy and cardiovascular outcomes.
Summary:
- Insulin therapy in type 2 diabetes leads to weight gain through reduced caloric loss from glycosuria, enhanced fatty acid storage in adipose tissue, and increased lean mass via positive nitrogen balance.
- Weight gain averages 6 kg in the first year, comprising 63% fat mass and 37% lean mass, irrespective of baseline obesity.
- The UKPDS 10-year follow-up demonstrated that insulin therapy prevents microangiopathy without increasing cardiovascular mortality compared to oral agents.
Impact:
- Weight gain is an expected consequence of insulin therapy but should not deter its initiation in poorly controlled type 2 diabetes.
- Insulin therapy offers significant benefits in preventing microvascular complications.
- This highlights the importance of balancing the side effect of weight gain with the established benefits of insulin therapy for type 2 diabetes management.