Early decrease in resting energy expenditure with bedtime insulin therapy.
OBJECTIVE
In type 2 diabetes (T2D), insulin-induced weight gain may stem from a reduction in resting energy expenditure (REE). We sought to determine the early effects of insulin introduction on REE in 20 poorly controlled T2D patients.


METHODS
After improving the glycaemia, REE was measured on Day 0 and Day 4 during two treatment regimens: bedtime insulin (n=10, group 1); and one off (3-day) intravenous insulin infusion (n=10, group 2).


RESULTS
Both groups were similar in age, gender, BMI, C-peptide, HbA(1c) and initial REE. By Day 4, fasting glycaemia had similarly improved in both groups: group 1: -5.3+/-2.7mmol/L vs group 2: -5.8+/-4.2 mmol/L. In group 2, the second REE was measured 12h after stopping the intravenous insulin infusion, whereas subcutaneous insulin was maintained in group 1. REE did not change in group 2 (-1.3+/-6.5%), whereas it decreased significantly in group 1 (-8.0+/-7.0%; P<0.05).


CONCLUSIONS
Bedtime insulin led to an early and specific reduction in REE.
Fagour
C
C
hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France. cedricfagour@hotmail.com
Gonzalez
C
C
Suberville
C
C
Higueret
P
P
Rabemanantsoa
C
C
Beauvieux
M-C
MC
Gin
H
H
Rigalleau
V
V
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012119:Respiration; D012146:Rest; D018709:Statistics, Nonparametric; D013997:Time Factors; D015430:Weight Gain / Q000187:drug effects
D001786:Blood Glucose; D002096:C-Peptide; D006442:Glycated Hemoglobin; D007328:Insulin