Efforts to improve glycaemic control in people with diabetes have encouraged more intensive therapeutic approaches. Hypoglycaemia is a risk associated with insulin therapy and a further consequence of intensified treatment is unwanted weight gain. The introduction of the long-acting insulin analogues, glargine and detemir, has provided a circulating insulin profile more reminiscent of normal basal insulin. This has allowed insulin dose escalation with a reduced risk of hypoglycaemia. The current study investigates the effect of switching treatment to insulin detemir in patients who had gained weight on insulin glargine therapy. Two months of treatment with insulin detemir did not alter glycaemic control or insulin dosage, but body weight was significantly reduced in patients with type 1 (p<0.05) and type 2 (p<0.005) diabetes. Br J Diabetes Vasc Dis 2008; 8: 183—186
Schwartz MWStaying slim with insulin in mind. Science2000;289: 2066-7.
2.
Schwartz MW, Porte DJDiabetes, obesity, and the brain. Science2005;307:375-9.
3.
Dornhorst A.Luddeke HJKoenen C. et al. PREDICTIVE Study Group.Transferring to insulin detemir from NPH insulin or insulin glargine in type 2 diabetes patients on basal-only therapy with oral antidiabetic drugs improves glycaemic control and reduces weight gain and risk of hypoglycaemia: 14-week follow-up data from PREDICTIVE. Diabetes, Obes Metab2008;10:75-81.
4.
Day C., Archer H., Bailey CJRecent advances in insulin therapy. Br J Cardiol2003;10:379-83.
5.
Home P., Bartley P., Russell-Jones D. et al. Study to Evaluate the Administration of Detemir Insulin Efficacy, Safety and Suitability (STEADINESS) Study Group.Insulin detemir offers improved glycemic control compared with NPH insulin in people with type 1 diabetes: a randomized clinical trial. Diabetes Care2004;27:1081-7.
6.
Russell-Jones D., Khan R.Insulin-associated weight gain in diabetes causes, effects and coping strategies. Diabetes, Obes Metab2007;9:799-812.
7.
The DCCT Research GroupWeight gain associated with intensive therapy in the diabetes control and complications trial. Diabetes Care1988;11: 567-73.
8.
UK Prospective Diabetes Study (UKPDS) Group.Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet1998;352:837-53.
9.
Holman RR, Thorne KI, Farmer AJ et al. Addition of Insulin to Oral Therapy in Type 2 Diabetes. New Engl J Med2007;357:1716-30.
10.
Yki-Jarvinen H., Ryysy L., Kauppila M. et al. Effect of obesity on the response to insulin therapy in noninsulin-dependent diabetes mellitus, J Clin Endocrinol Metab1997;82:4037-43.
11.
Williamson DF, Thompson TJ, Thun M. et al. Intentional weight loss and mortality among overweight individuals with diabetes. Diabetes Care2000;23:1451-52.
12.
Ridderstrale M., Gudbjornsdottir S., Eliasson B. et al. Steering committee of the Swedish National Diabetes Register (NDR). Obesity and cardiovascular risk factors in type 2 diabetes: results from the Swedish National Diabetes Register. J Int Med2006;259:314-22.
13.
Dornhorst A. , Lueddeke HJ, Sreenan S. et al. Insulin detemir improves glycaemic control without weight gain in insulin-naive patients with type 2 diabetes: subgroup analysis from the PREDICTIVE qTM study. Int J Clin Pract2008;62:659-65.
14.
Hordern SV, Wright JE, Umpleby A. et al. Comparison of the effects on glucose and lipid metabolism of equipotent doses of insulin detemir and NPH insulin with a 16-h euglycaemic clamp. Diabetologia2005; 48:420-26.
15.
Tibaldi J.Actions of insulin beyond glycemic control: a perspective on insulin detemir . Advances in Therapy2007;24:868-82.
