Factors associated with weight gain in people with type 2 diabetes starting on insulin.
OBJECTIVE
Moderate weight gain is usual after starting insulin therapy. The identification and quantification of factors associated with weight gain may help target strategies for avoidance of weight gain.


METHODS
The noninterventional CREDIT (Cardiovascular Risk Evaluation in people with type 2 Diabetes on Insulin Therapy) study included data from people with type 2 diabetes starting any insulin in 314 centers, in 12 countries. From a number of predefined candidate explanatory variables, analyses identified factors associated with weight gain 1 year after starting insulin treatment, after adjusting for investigational site as a random factor. A multivariable backward regression analysis selected a subset of these factors associated with weight gain.


RESULTS
We studied the 2,179 people with data for body weight change at 1 year and for potential predictive factors. The mean weight gain was 1.78 kg, and 24% gained ≥5.0 kg. Baseline factors associated with weight gain were BMI, A1C, insulin regimen, insulin dose, other glucose-lowering therapies, and hypertension; at 1 year, additional factors were A1C, insulin regimen, insulin dose, and use of other glucose-lowering therapies. In multivariable analysis, weight gain at 1 year was associated with a higher A1C at baseline, a higher insulin dose at baseline and at 1 year, and a lower baseline BMI.


CONCLUSIONS
By the time insulin was started, a high baseline A1C and insulin dose requirements were independently associated with greater weight gain, as was lower baseline BMI. Insulin regimen per se was not a predictive factor.
INSERM Centre for Research in Epidemiology and Population Health, U1018, Villejuif, FranceUniversity Paris-Sud, URMS 1018, Villejuif, France beverley.balkau@inserm.fr.
Beverley
B
Balkau
Newcastle University, Newcastle upon Tyne, U.K.
Philip D
PD
Home
Sanofi, Paris, France.
Maya
M
Vincent
INSERM U695, University of Paris 7, Paris, France.
Michel
M
Marre
University College London, London, U.K.
Nick
N
Freemantle
D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000517:prevention & control*; D003925:Diabetic Angiopathies / Q000097:blood / Q000517:prevention & control*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects*
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin