title: Increase of body weight during the first year of intensive insulin treatment in type 2 diabetes: systematic review and meta-analysis.
abstract: OBJECTIVE
  This systematic review and meta-analysis was to evaluate the body weight increase and its clinical correlates, through direct weighted regressions, as well as the effect of different insulin regimens and insulin analogues, through meta-analysis.
  
  
  METHODS
  Appropriate methodology according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was adhered to. Forty-six randomized studies, published as full papers, reporting the effect of insulin treatment on change in body weight were identified, and used to identify predictors of weight change; studies were included in a meta-analysis to study the effect of different insulin regimens or insulin analogues on weight change.
  
  
  RESULTS
  Intensity of treatment [aim of study (fasting blood glucose, mg/dl), dose of insulin, final HbA1c, change of HbA1c and frequency of hypoglycaemia] was significantly associated with body weight increase, with small differences between basal versus twice-a-day and prandial regimen. At meta-analysis, body weight increase was lower with basal regimen than with twice-a-day regimen and than with a prandial regimen. Within all regimens, body weight increase was lower with detemir than with NPH, with no difference between glargine and NPH; only two studies directly compared detemir and glargine, indicating lower weight gain with the former insulin. Within twice-a-day regimens and within prandial regimens, comparison was between newer analogues and older drugs, with no significant difference in body weight increase.
  
  
  CONCLUSIONS
  Body weight increase during the first year of insulin treatment is associated with the intensity of treatment; body weight increase also depends on the insulin regimen applied.
authors.affiliation: Cattedra di Medicina Interna e Cattedra di Biometria, Dipartimento di Medicina, Chirurgia e Odontoiatria, Università degli Studi di Milano and Ospedale San Paolo, Milano, Italy. antonio.pontiroli@unimi.it
authors.forename: A E
authors.initials: AE
authors.lastname: Pontiroli
authors.forename: L
authors.initials: L
authors.lastname: Miele
authors.forename: A
authors.initials: A
authors.lastname: Morabito
mesh_terms: D015415:Biomarkers / Q000097:blood; D001835:Body Weight / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects* / Q000031:analogs & derivatives; D008297:Male; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin