Contribution of change in glycosylated haemoglobin to insulin-associated weight gain: results of a longitudinal study in type 2 diabetic patients

Abstract

To investigate the contribution of glycosylated haemoglobin change (HbA1c) on body weight in patients with type 2 diabetes after start of insulin therapy. We analysed 122 individual weight-profiles in relation to the change in HbA1c per se in these patients up to 36months after the start of insulin therapy. Data were analysed separately for the first 9months after commencement of insulin therapy and for the period thereafter. Within the first 9months of insulin therapy mean body weight increased by 0.52kg per month. HbA1c decreased from 9.9±1.8 to 7.9±1.3%. Only 12% of the initial weight gain could be attributed to the change in HbA1c. Furthermore, the mean monthly increase in body weight gain was reduced by 0.006kg for every 1kg higher body weight at baseline. From 9 to 36months after start of insulin therapy, body weight increased by 0.1kg/month, which was independent of change in HbA1c. Improvement of glycaemic control per se contributes little to initial weight gain after start of insulin therapy in patients with T2DM. After 9months of insulin treatment, weight gain is unrelated to change in glycosylated haemoglobin. Other factors have to be responsible for weight gain after start of insulin therapy.