title: Prediction of excessive weight gain in insulin treated patients with type 2 diabetes.
abstract: Weight gain is an ongoing challenge when initiating insulin therapy in patients with type 2 diabetes mellitus (T2DM). However, if prediction of insulin-associated weight gain was possible on an individual level, targeted initiatives could be implemented to reduce weight gain. The aim of the present study was to identify predictors of weight gain in insulin-treated patients with T2DM.
  
  
  
  In all, 412 individuals with T2DM were, in addition to metformin or placebo, randomized into 18-month treatment groups with three different insulin analog treatment regimens (biphasic, aspart, detemir). Participants with excessive weight gain were defined as the group with weight gain in the 4th quartile (>6.2 kg).We developed a pattern classification method to predict individuals prone to excessive weight gain.
  
  
  
  Over the 18-month treatment period, median weight gain among all 412 patients was 2.4 kg (95% prediction interval [PI] -5.6, 12.4 kg), whereas median weight gain for those in the upper 4th quartile (n = 103) was 8.9 kg (95% PI 6.3, 15.2 kg). No clinical baseline data were strong predictors of excessive weight gain. However, the weight gain during the first 3 months of the trial and the subsequent dose of insulin yielded a useful predictor for weight gain at the 18-month follow-up. Combining these two predictors into a prediction model with other clinical available information produced a receiver operating characteristic area under the curve of 0.80.
  
  
  
  We have developed a prediction model that could help identify a substantial proportion of individuals with T2DM prone to large weight gain during insulin therapy.
authors.affiliation: Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: Simon Lebech
authors.initials: SL
authors.lastname: Cichosz
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.|Department of Endocrinology PE, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Louise
authors.initials: L
authors.lastname: Lundby-Christensen
authors.affiliation: Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: Mette D
authors.initials: MD
authors.lastname: Johansen
authors.affiliation: Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.|Department of Clinical Epidemiology, Nordsjaellands Hospital, Hilleroed, Denmark.|Department of Clinical Research, Nordsjaellands Hospital, Hilleroed, Denmark.|Department of Endocrinology PE, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Lise
authors.initials: L
authors.lastname: Tarnow
authors.affiliation: Steno Diabetes Center, Gentofte, Denmark.
authors.forename: Thomas Peter
authors.initials: TP
authors.lastname: Almdal
authors.affiliation: Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: Ole K
authors.initials: OK
authors.lastname: Hejlesen
mesh_terms: D000368:Aged; D061265:Biphasic Insulins / Q000009:adverse effects / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D061267:Insulin Aspart / Q000009:adverse effects / Q000627:therapeutic use*; D000069057:Insulin Detemir / Q000009:adverse effects / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D011379:Prognosis; D013997:Time Factors; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D061265:Biphasic Insulins; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D061267:Insulin Aspart; D000069057:Insulin Detemir; D008687:Metformin
keywords: diabetes; insulin; prediction; weight gain; 体重增加; 糖尿病; 胰岛素; 预测