title: Factors associated with insulin-induced weight gain in an Australian type 2 diabetes outpatient clinic.
abstract: BACKGROUND
  Insulin-induced weight gain is a key concern for people with type 2 diabetes (T2D) and their treatment team. This study aimed to document the prevalence of insulin-induced weight gain and its impact on cardiovascular risk factors in patients attending the Royal Melbourne Hospital diabetes clinic.
  
  
  METHODS
  Clinical and biochemical data were extracted from a prospective clinic database and from the hospital record. These variables were correlated with the percentage weight change 1 year after starting insulin and compared between groups with or without clinically significant weight gain, defined as more than 7% of the baseline bodyweight.
  
  
  RESULTS
  The population comprised 340 patients (184 male), representing 36% of people with T2D who commenced insulin at our clinic. Their mean ± SD age and duration of diabetes was 63 ± 11 and 13 ± 8 years respectively. The mean (95% CI) change in bodyweight at 1 year was 3.0 (2.5-3.5) kg, but this was not associated with deleterious changes in blood pressure or lipid profile. Weight gain was associated with higher insulin doses, the use of short-acting insulin and with lower baseline bodyweight. Clinically significant weight gain occurred in 87 patients and was associated with glucose-lowering regimens that included short-acting insulin or a thiazolidinedione, whereas regimens that incorporated other oral agents, particularly sulfonylureas, were associated with less weight gain.
  
  
  CONCLUSIONS
  In this Australian tertiary hospital population with T2D, insulin-induced weight gain was common but was not associated with deleterious changes in blood pressure or lipids. Treatment regimens that avoid short-acting insulin but include oral agents other than thiazolidinediones might prevent insulin-induced weight gain in T2D.
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Yadgar-Yalda
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: P G
authors.initials: PG
authors.lastname: Colman
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Fourlanos
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.|Department of Population Health and Immunity, Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia.
authors.forename: J M
authors.initials: JM
authors.lastname: Wentworth
mesh_terms: D000368:Aged; D001315:Australia; D001786:Blood Glucose / Q000032:analysis; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: insulin-induced weight gain; obesity; type 2 diabetes