NEW PUBLICATION Can we predict weight gain during insulin therapy in type 2 diabetes ?

Weight gain  is  an unwanted side effect of insulin treatment. This study documents that  the increase in serum leptin levels preceeds  and correlates with weight gain during insulin treatment in type 2 diabetes. This was a post hoc  analysis of two randomized, controlled trials.I ncluded were in all  67  poorly controlled on oral hypoglycemic agent (OHA)-treated type 2 diabetic subjects. INTERVENTION. 1 yr treatment with either OHAs and lifestyle intervention or insulin with or without concomitant lifestyle intervention. MAIN OUTCOME MEASURE: Changes in serum leptin levels during clamp and during 1 yr of treatment in relationship to changes in body weight. RESULTS: Study 1: during acute insulin infusion leptin levels increased by 10% (P < 0.001). During 1 yr of insulin therapy, mean body weight increased by 6%, whereas the fasting leptin levels increased by 108% (both P < 0.001). The weight gain observed at 1 yr correlated with the increase in leptin levels observed during the clamp (r = 0.62, P = 0.003). Study 2: mean body weight increased by 4% (P < 0.01), whereas leptin levels increased by 56% (P < 0.001) during 1 yr of insulin treatment and the increase in leptin preceded the increase in body weight.

CONCLUSIONS: Significant correlations were observed between insulin’s effect on serum leptin levels and the increase in weight that accompanied insulin therapy. This may point to important  pathogenic aspects of weight gain following insulin treatment.

Aas AM, Hanssen KF, Berg JP, Thorsby PM, Birkeland KI. Insulin-stimulated increase in serum leptin levels precedes and correlates with weight gain during insulin therapy in type 2 diabetes.J Clin Endocrinol Metab. 2009 ;94:2900-6.