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Insulin-associated weight gain in obese type 2 diabetes mellitus patients: What can be done?

Brown, A; Guess, N; Dornhorst, A; Taheri, S; Frost, G; (2017) Insulin-associated weight gain in obese type 2 diabetes mellitus patients: What can be done? Diabetes, Obesity and Metabolism , 19 (12) pp. 1655-1668. 10.1111/dom.13009. Green open access

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Abstract

Insulin therapy (IT ) is initiated for patients with type 2 diabetes mellitus when glycaemic targets are not met with diet and other hypoglycaemic agents. The initiation of IT improves glycaemic control and reduces the risk of microvascular complications. There is, however, an associated weight gain following IT , which may adversely affect diabetic and cardiovascular morbidity and mortality. A 3 to 9 kg insulin‐associated weight gain (IAWG ) is reported to occur in the first year of initiating IT , predominantly caused by adipose tissue. The potential causes for this weight gain include an increase in energy intake linked to a fear of hypoglycaemia, a reduction in glycosuria, catch‐up weight, and central effects on weight and appetite regulation. Patients with type 2 diabetes who are receiving IT often have multiple co‐morbidities, including obesity, that are exacerbated by weight gain, making the management of their diabetes and obesity challenging. There are several treatment strategies for patients with type 2 diabetes, who require IT , that attenuate weight gain, help improve glycaemic control, and help promote body weight homeostasis. This review addresses the effects of insulin initiation and intensification on IAWG , and explores its potential underlying mechanisms, the predictors for this weight gain, and the available treatment options for managing and limiting weight gain.

Type: Article
Title: Insulin-associated weight gain in obese type 2 diabetes mellitus patients: What can be done?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/dom.13009
Publisher version: https://doi.org/10.1111/dom.13009
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Endocrinology & Metabolism, insulin therapy, insulin-associated weight gain, type 2 diabetes, obesity, weight loss interventions, predictors, mechanisms, LOW-CALORIE DIET, LOW-CARBOHYDRATE DIET, LOW-FAT DIET, LIFE-STYLE INTERVENTION, BLOOD-GLUCOSE CONTROL, Y GASTRIC BYPASS, IMPROVES GLYCEMIC CONTROL, ORAL HYPOGLYCEMIC AGENTS, BETA-CELL FUNCTION, BARIATRIC SURGERY
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Experimental and Translational Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10102387
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