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Weight gain and insulin treatment
1Service d'Endocrinologie-Diabétologie-Nutrition, Hôpital Bichat, France. etienne.larger@bch.aphp.fr
Diabetes & Metabolism
|January 5, 2006
Summary
Insulin therapy for diabetes leads to modest weight gain, primarily "catch-up" weight. This weight gain does not worsen cardiovascular risk factors, and insulin detemir shows less weight gain than NPH insulin.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Pharmacology
Background:
- Weight gain is a common concern for patients initiating insulin therapy for diabetes.
- Previous beliefs suggested insulin-induced weight gain could negatively impact cardiovascular health.
Purpose of the Study:
- To review recent data on weight gain associated with insulin treatment in type 1 and type 2 diabetes.
- To investigate factors influencing weight gain after insulin initiation.
- To assess the impact of insulin-associated weight gain on cardiovascular risk factors.
Main Methods:
- Review of clinical studies and data on insulin therapy in diabetic patients.
- Analysis of weight changes in patients on intensified insulin therapy versus conventional treatments.
- Examination of correlations between weight gain and metabolic control, prior weight loss, and family history.
Main Results:
- Excess weight gain with intensified insulin therapy is modest (e.g., 2.6 kg over 7.5 years in type 1, 1.7 kg over 10 years in type 2).
- Weight gain is more pronounced in patients with poorer initial metabolic control, prior weight loss, or a family history of type 2 diabetes (in type 1).
- No evidence links insulin-associated weight gain to worsened lipid profiles, hypertension, or cardiovascular events.
- Insulin detemir is associated with less weight gain compared to NPH insulin.
Conclusions:
- Weight gain following insulin initiation is largely a 'catch-up' phenomenon and not detrimental to cardiovascular health.
- Insulin therapy, particularly with analogues like detemir, offers a favorable weight profile compared to older insulins.
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