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CREDIT: Non-traditional risk factors contribute to weight gain during insulin therapy
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EASD 47th Annual Meeting
LISBON — Recognizing non-traditional risk factors that may contribute to weight gain at the start of insulin therapy among patients with type 2 diabetes could be beneficial in real-life clinical practice, researchers said here.
According to results of the CREDIT study, increased weight gain occurred among insulin users who had a higher HbA1c at baseline; had a lower BMI; less frequently used concomitant glucose-lowering medications; did not start basal insulin; and were using multiple insulin injection regimens. Additionally, higher insulin dose at 1 year was associated with more weight gain; slightly higher HbA1c persisted among patients who gained weight.
“Insulin dose at 1 year was the strongest predictor of weight gain, independent of baseline BMI or HbA1c,” Beverley Balkau, PhD, of INSERM CESP U1018 in France, said during an oral session. “Higher baseline BMI was associated with less weight gain, thus baseline obesity should not be an impediment for appropriate insulin treatment. A higher baseline HbA1c and tri-therapy with oral agents were associated with weight gain even after controlling for insulin dose.”
The non-interventional trial was conducted at 314 centers in 12 countries and included 2,442 patients with type 2 diabetes. Data on the change in weight 1-year after insulin therapy initiation were available. Balkau and colleagues compared factors associated with a median weight gain >1.6 kg at baseline and follow-up.
Weight gain varied across countries, with 34% of patients in Croatia gaining ≥1.6 kg to 72% in Portugal (P<.001), according to the study abstract.
At study commencement, the patients’ insulin treatment was as follows: 52% basal insulin alone; 23% pre-mix insulin; and 25% other insulin. At 1 year the numbers of patients using the specific treatments increased to 41%, 27% and 30%, respectively.
Age, sex, smoking status, lipid profile, the existence of microvascular or macrovascular disease and prior treatment for diabetes were not associated with increased weight gain during insulin treatment. – by Stacey L. Fisher
For more information:
- Balkau B. Abstract #113. Presented at: The European Association for the Study of Diabetes 47th Annual Meeting; Sept. 12-16, 2011; Lisbon.
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