Determinants of weight change in patients on basal insulin treatment: an analysis of the DIVE registry.
OBJECTIVE
We aimed to describe patterns of weight change in insulin-naive patients with type 2 diabetes mellitus (T2DM) starting basal insulin (BI) treatment.


METHODS
Diabetes Versorgungs-Evaluation (DIVE) is an observational, multicenter, prospective registry in patients with T2DM. Patients were divided into those initiating BI therapy for the first time (with optional oral antidiabetic drugs (OADs)) and those initiating OADs only (OADo).


RESULTS
521 patients were included in the analysis, 113 in the BI arm and 408 in the OADo arm. Relative to baseline, the BI group gained an average of 0.98±7.1 kg at 1 year, compared with a loss of 1.52±11.8 kg in the OADo group (p<0.001). This difference remained statistically significant when expressed as a proportional change from baseline (+0.014±0.08 vs -0.015±0.12, respectively (p<0.001)). Baseline weight (regression coefficient (RC) 0.89; 95% CI 0.81 to 0.97; p<0.001) and diabetes duration (RC 2.52; 95% CI 0.53 to 4.52; p=0.01) were the only factors identified as significant predictors of weight gain between baseline and 1 year follow-up in BI patients.


CONCLUSIONS
Though BI therapy leads to modest weight gain over the subsequent year, this may be limited by BI initiation at an early stage of the disease. As such, delaying the start of insulin therapy based on fears of weight gain appears counter-productive, and should be reconsidered.
Institut für Pharmakologie und Präventive Medizin , Mahlow , Germany.
Peter
P
Bramlage
Institute for Statistics, Ulm University , Ulm , Germany.
Tobias
T
Bluhmki
Sanofi Aventis Deutschland GmbH , Berlin , Germany.
Holger
H
Fleischmann
winDiab GmbH, Düsseldorf, Germany; Gemeinschaftspraxis Kaltheuner-v. Boxberg, Leverkusen, Germany.
Matthias
M
Kaltheuner
Institute for Statistics, Ulm University , Ulm , Germany.
Jan
J
Beyersmann
Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany; German Center for Diabetes Research (DZD), Munich-Neuherberg, Neuherberg, Germany.
Reinhard W
RW
Holl
Kinder- und Jugendkrankenhaus "AUF DER BULT" , Hannover , Germany.
Thomas
T
Danne
Adult Diabetes; Body Weight; Insulin; Oral Antidiabetics