WEIGHT GAIN WITH INSULIN THERAPY IN TYPE 2 DIABETES PATIENTS FAILING ORAL ANTIDIABETIC DRUGS
Type 2 diabetes mellitus is a disease with progressive beta-cell decline and most patients will require insulin therapy to control their glycemic homeostasis. The aims of this study is to estimate the weight gain associated with insulin therapy in type 2 diabetes patients failing oral antidiabetic drugs. We retrospectively evaluated 58 patients, 36 women (62.06%) and 22 men (37.93%), with type 2 diabetes who required insulin for poor metabolic control, despite dietary measures and maximal- dose oral agents. The subjects were between 47 and 71 years. 25 patients required analog insulin and 33 patients biosynthetic human insulin. The insulin regimes were conventional treatment (basal insulin, premixed insulin-11 patients in treatment with analog insulin, and 15 patients with biosynthetic human insulin) or intensive- treatment (basal/bolus insulin-14 patients in treatment with analog insulin and 18 patients with biosynthetic human insulin). The following parameters were determined at the beginning of the study, and were monitored over 5 years of insulinotherapy: weight, glycosylated hemoglobin (HbA1c), insulin requirement and types of insulin. Mean age at the diagnosis of diabetes was 50.16 ± 5.39 years (range 38-62 years) and mean age at insulin introduction was 55.80 ± 6-16 years (range 42- 71 years). Mean weight at insulin introduction was 71.00 ± 9.50 kg (range 58-101 kg), after 1 year 73.92 ± 9.47 kg (range 63-105 kg) and after 5 years 76.71 ±. 9.71kg (range 67-107 kg). The mean baseline levels of HbA1c was 9.61 ± 0.80% and after 5 years of insulin therapy 8.02 ± 0.44%. The mean weight gain in the study group after 1 year from started insulin was 2.86 ± 0.86 kg and after 5 years 6.08 ±1.59 kg. The weight gain was directly correlated with the insulin dose. Weight gain was significantly greater in the intensive-treatment group compared with the conventional-treatment group.