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Weight gain in type 2 diabetes mellitus
A N Jacob1, K Salinas, B Adams-Huet
1Department of Internal Medicine, University of Texas Southwestern Medical Center in Dallas, Dallas, TX 75390-8858, USA.
Diabetes, Obesity & Metabolism
|March 30, 2007
Summary
Weight gain in type 2 diabetes patients on insulin therapy is likely due to decreased resting energy expenditure and improved glycemic control, not increased food intake. Subcutaneous fat also increased in some groups.
Area of Science:
- Endocrinology
- Metabolism
- Diabetes Research
Background:
- Insulin and combination therapies are common for type 2 diabetes.
- Weight gain is a frequent side effect of these treatments.
- Understanding the mechanisms behind weight gain is crucial for patient management.
Purpose of the Study:
- To investigate the causes of weight gain in type 2 diabetes patients treated with insulin monotherapy or combination therapies.
- To assess the impact of insulin, metformin, and pioglitazone on energy expenditure, intake, and body composition.
Main Methods:
- Open-label, prospective study of 6-month duration with 57 participants.
- Randomization to insulin monotherapy, insulin + pioglitazone, or insulin + metformin.
- Measurements included weight, HbA1c, resting energy expenditure (REE), energy intake, body fat, and hormonal levels.
Main Results:
- Significant weight gain (approx. 7.1-7.6 kg) observed across all groups.
- HbA1c levels improved in all groups, correlated with weight gain.
- Resting energy expenditure per lean mass decreased (p=0.04).
- Subcutaneous fat areas increased in insulin monotherapy and pioglitazone groups.
Conclusions:
- Weight gain is likely due to increased fuel efficiency from improved glycemic control and reduced REE, not increased caloric intake.
- Decreased glycosuria also contributed to weight gain.
- Insulin and pioglitazone therapies led to increased subcutaneous fat accumulation.
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