title: Composition of insulin-induced body weight gain in diabetic patients: a bio-impedance study.
abstract: Although insulin is a well-known cause of body weight gain, it is not clear whether it is due to the accumulation of fat or lean mass. We performed a 3 months Body-Impedance Analysis follow-up in 72 diabetic patients in a wide range of insulin indications: insulin introduction in young inaugural type 1 diabetics (n = 12), late-onset type 1 (n = 12), type 2 affected by intercurrent diseases (n = 12) or microangiopathic complications (n = 12), type 2 with failure of oral antidiabetic agents (n = 12), and insulin withdrawal in type 2 (n = 12). In type 1 patients, insulin led to the most important weight gain, but it was fat-free, with a major benefit on HbA1C. Type 2 patients affected by intercurrent diseases or microangiopathic complications had a mild, also fat-free weight gain, with a clear benefit on HbA1C. In type 2 patients with failure of oral agents, HbA1C declined less, weight gain was intermedia, but predominantly fat, mirrored by a predominant fat loss in type 2 patients whose insulin was stopped (without significant change in HbA1C). Both fat and lean mass contributed to insulin-induced body weight gain, but a significant negative relationship existed between their respective evolution in our patients (r = -0.23, p < 0.05 by linear regression analysis between delta fat mass and delta lean mass). Insulin-induced body weight gain is not univocal: insulin restaures or protects lean mass in its less controversial indications, whereas it leads to fat accumulation in type 2 patients with isolated failure of oral agents.
authors.affiliation: Hôpital Haut-Lévêque, Pessac, France.
authors.forename: V
authors.initials: V
authors.lastname: Rigalleau
authors.forename: C
authors.initials: C
authors.lastname: Delafaye
authors.forename: L
authors.initials: L
authors.lastname: Baillet
authors.forename: V
authors.initials: V
authors.lastname: Vergnot
authors.forename: P
authors.initials: P
authors.lastname: Brunou
authors.forename: B
authors.initials: B
authors.lastname: Gatta
authors.forename: H
authors.initials: H
authors.lastname: Gin
mesh_terms: D000328:Adult; D000368:Aged; D001823:Body Composition / Q000187:drug effects*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D003925:Diabetic Angiopathies / Q000188:drug therapy; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007328:Insulin / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012727:Sex Characteristics; D013375:Substance Withdrawal Syndrome; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin