Initiation of once daily insulin detemir is not associated with weight gain in patients with type 2 diabetes mellitus: results from an observational study

Diabetology & Metabolic Syndrome

Stuart A Ross⁵  Anne Louise Svendsen⁸  Florian MM Baeres²  Andreas Liebl⁹  Kamlesh Khunti¹  Eddy Karnieli⁶  Marcel Kaiser³  Taner Damci⁴  Jean-François Yale⁷ 

[1] Diabetes Research Centre, University of Leicester, Leicester, UK;Global Medical Affairs, Novo Nordisk A/S, Søborg, Denmark;Practice for Internal Medicine and Diabetology, Frankfurt, Germany;Department of Endocrinology, Cerrahpasa Medical School, Diabetes and Metabolism, Istanbul University, Istanbul, 34363, Turkey;University of Calgary, Calgary, Alberta, Canada;Endocrinology, Diabetes & Metabolism, Rambam Medical Center and Rappaport Faculty of Medicine, Technion, Haifa, Israel;McGill Nutrition and Food Science Centre, Royal Victoria Hospital, Montreal, Quebec, Canada;Department of Biostatistics & Epidemiology, Novo Nordisk A/S, Søborg, Denmark;Center for Diabetes and Metabolism, m&i-Fachklinik Bad Heilbrunn, Wörnerweg 30, Bad Heilbrunn, 83670, Germany

关键词: Hypoglycaemia;    Insulin dose;    Body mass index;    Weight;    Insulin therapy;    Type 2 diabetes mellitus;   

Others  :  812684
DOI  :  10.1186/1758-5996-5-56

 received in 2013-07-11, accepted in 2013-09-25,  发布年份 2013

【 摘 要 】

Background

Obesity is common in type 2 diabetes (T2DM) and is associated with increased risk of morbidity and all-cause mortality. This analysis describes weight changes associated with insulin detemir initiation in real-life clinical practice.

Methods

Study of Once-Daily Levemir (SOLVE) was a 24-week international observational study of once-daily insulin detemir as add-on therapy in patients with T2DM receiving oral hypoglycaemic agents (OHAs).

Results

17,374 participants were included in the analysis: mean age 62 ± 12 years; weight 80.8 ± 17.6 kg; body mass index (BMI) 29.2 ± 5.3 kg/m²; diabetes duration 10 ± 7 years; HbA1c 8.9 ± 1.6%. HbA1c decreased by 1.3 ± 1.5% during the study, with insulin doses of 0.27 ± 0.17 IU/kg. Patients with higher BMI had higher pre-insulin HbA1c, and similar reductions in HbA1c with insulin therapy. Weight decreased from 80.8 ± 17.6 kg to 80.3 ± 17.0 kg (change of -0.6 [95% CI -0.65; -0.47] kg), with 35% of patients losing >1 kg. Patients with the highest pre-insulin BMI lost the greatest amount of weight: BMI < 25: +0.8 [95% CI: 0.6; 0.9] kg, 25 ≤ BMI < 30: -0.2 [95% CI: -0.3; -0.8] kg, 30 ≤ BMI < 35: -1.0 [95% CI: -1.1; -0.8] kg; BMI ≥ 35: -1.9 [95% CI: -2.2; -1.6] kg. Minor hypoglycaemia decreased with increasing BMI: 2.3 and 1.3 events per patient year for BMI <25 and  ≥ 35, respectively.

Conclusions

Overall, patients with poorly controlled T2DM achieved significant reductions in HbA1c after initiation of once-daily insulin detemir therapy, without weight gain. The favourable impact of insulin detemir on weight may not apply to other insulin preparations.

Trial registrations

ClinicalTrials.gov, NCT00825643 and NCT00740519

【 授权许可】

   
2013 Yale et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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