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Insulin detemir reduces weight gain as a result of reduced food intake in patients with type 1 diabetes.

Zachariah S, Sheldon B, Shojaee-Moradie F, Jackson NC, Backhouse K, Johnsen S, Jones RH, Umpleby AM, Russell-Jones DL - Diabetes Care (2011)

Bottom Line: We investigated whether this effect was a result of reduced energy intake and/or increased energy expenditure.Leptin was lower and resistin was higher with insulin detemir compared with NPH insulin (P=0.039, P=0.047).The reduced weight gain with insulin detemir compared with NPH insulin is attributed to reduced energy intake rather than increased energy expenditure.

View Article: PubMed Central - PubMed

Affiliation: 1Department of Diabetes and Endocrinology, Royal Surrey County Hospital, and Diabetes and Metabolic Medicine, Postgraduate Medical School, University of Surrey, Guildford, UK. zachariah_sunil@hotmail.com

ABSTRACT

Objective: Insulin detemir lacks the usual propensity for insulin to cause weight gain. We investigated whether this effect was a result of reduced energy intake and/or increased energy expenditure.

Research design and methods: A 32-week, randomized crossover design trial was undertaken in 23 patients with type 1 diabetes. Patients on a basal-bolus regimen (with insulin aspart as the bolus insulin) were randomly assigned to insulin detemir or NPH insulin as a basal insulin for 16 weeks, followed by the other basal insulin for 16 weeks. At the end of each 16-week period, total energy expenditure, resting energy expenditure, diet-induced thermogenesis, activity energy expenditure, energy intake, weight change, glycemic control, hypoglycemic episodes, and hormones that affect satiety and fuel partitioning were measured.

Results: After 16 weeks, weight change was -0.69±1.85 kg with insulin detemir and +1.7±2.46 kg with NPH insulin (P<0.001). Total energy intake was significantly less with insulin detemir (2,016±501 kcal/day) than with NPH insulin (2,181±559 kcal/day) (P=0.026). There was no significant difference in any measure of energy expenditure, HbA1c percentage, or number of hypoglycemic episodes. Leptin was lower and resistin was higher with insulin detemir compared with NPH insulin (P=0.039, P=0.047). After the meal, ghrelin and pancreatic polypeptide levels (P=0.002, P=0.001) were higher with insulin detemir.

Conclusions: The reduced weight gain with insulin detemir compared with NPH insulin is attributed to reduced energy intake rather than increased energy expenditure. This may be mediated by a direct or indirect effect of insulin detemir on the hormones that control satiety.

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Related in: MedlinePlus

Mathematical model showing the relationships between changes in measured variables. +, Significant positive relationship; −, Significant negative relationship.
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Figure 2: Mathematical model showing the relationships between changes in measured variables. +, Significant positive relationship; −, Significant negative relationship.

Mentions: The model showed a positive relationship between weight and leptin, between weight and fat-free mass, and between weight and pancreatic polypeptide (Fig. 2). Additional negative relationships were observed between food intake and leptin, between resistin and leptin, between pancreatic polypeptide and fat-free mass, and between ghrelin and fat-free mass.


Insulin detemir reduces weight gain as a result of reduced food intake in patients with type 1 diabetes.

Zachariah S, Sheldon B, Shojaee-Moradie F, Jackson NC, Backhouse K, Johnsen S, Jones RH, Umpleby AM, Russell-Jones DL - Diabetes Care (2011)

Mathematical model showing the relationships between changes in measured variables. +, Significant positive relationship; −, Significant negative relationship.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3120205&req=5

Figure 2: Mathematical model showing the relationships between changes in measured variables. +, Significant positive relationship; −, Significant negative relationship.
Mentions: The model showed a positive relationship between weight and leptin, between weight and fat-free mass, and between weight and pancreatic polypeptide (Fig. 2). Additional negative relationships were observed between food intake and leptin, between resistin and leptin, between pancreatic polypeptide and fat-free mass, and between ghrelin and fat-free mass.

Bottom Line: We investigated whether this effect was a result of reduced energy intake and/or increased energy expenditure.Leptin was lower and resistin was higher with insulin detemir compared with NPH insulin (P=0.039, P=0.047).The reduced weight gain with insulin detemir compared with NPH insulin is attributed to reduced energy intake rather than increased energy expenditure.

View Article: PubMed Central - PubMed

Affiliation: 1Department of Diabetes and Endocrinology, Royal Surrey County Hospital, and Diabetes and Metabolic Medicine, Postgraduate Medical School, University of Surrey, Guildford, UK. zachariah_sunil@hotmail.com

ABSTRACT

Objective: Insulin detemir lacks the usual propensity for insulin to cause weight gain. We investigated whether this effect was a result of reduced energy intake and/or increased energy expenditure.

Research design and methods: A 32-week, randomized crossover design trial was undertaken in 23 patients with type 1 diabetes. Patients on a basal-bolus regimen (with insulin aspart as the bolus insulin) were randomly assigned to insulin detemir or NPH insulin as a basal insulin for 16 weeks, followed by the other basal insulin for 16 weeks. At the end of each 16-week period, total energy expenditure, resting energy expenditure, diet-induced thermogenesis, activity energy expenditure, energy intake, weight change, glycemic control, hypoglycemic episodes, and hormones that affect satiety and fuel partitioning were measured.

Results: After 16 weeks, weight change was -0.69±1.85 kg with insulin detemir and +1.7±2.46 kg with NPH insulin (P<0.001). Total energy intake was significantly less with insulin detemir (2,016±501 kcal/day) than with NPH insulin (2,181±559 kcal/day) (P=0.026). There was no significant difference in any measure of energy expenditure, HbA1c percentage, or number of hypoglycemic episodes. Leptin was lower and resistin was higher with insulin detemir compared with NPH insulin (P=0.039, P=0.047). After the meal, ghrelin and pancreatic polypeptide levels (P=0.002, P=0.001) were higher with insulin detemir.

Conclusions: The reduced weight gain with insulin detemir compared with NPH insulin is attributed to reduced energy intake rather than increased energy expenditure. This may be mediated by a direct or indirect effect of insulin detemir on the hormones that control satiety.

Show MeSH
Related in: MedlinePlus