Dinamika massy tela u bol'nykh sakharnymdiabetom 2 tipa v techenie pervogo godainsulinoterapii

Abstract

The aim of this study was to determine changes in weight and insulin requirements in insulin-treated type 2 diabetic patients with normal and elevated body mass index (BMI) during the first year after initiating the insulin therapy with insulin analogues or human insulins, respectively. Materials and methods: a total of 157 patients with insulin naive type 2 diabetes were included in the study. The patients were divided in two groups. First group consisted of subjects [mean age 57 (45 to 73), duration of diabetes of 10 years (4 to 16)] prescribed a long-acting basal (glargine, detemir), premixed (biphasic insulin Aspart 30, Humalog Mix 25) or short-acting (aspart, lispro) insulin analogues. Patients from second group [mean age 59 (46 to 75), duration of diabetes for 10 years (5 to 15)] were treated with intermediate- acting basal (Protophane, Humulin NPH), premixed (biphasic human insulin 30, Humulin M3) and regular (Actrapid, Humulin R) human insulins. Each of these two groups was divided into three subgroups depending on the baseline body mass index (BMI) of the patients: 18,5-24,9; 25-29 and ≥30. At the beginning of insulin therapy and 12 months later, we compared HbA1c, BMI, waist circumference and required insulin doses in each group. Results: our study results showed that under comparable metabolic control the risk for weight gain and increase in insulin requirement is similar in insulin-treated type 2 diabetic patients with normal and elevated BMI. Use of insulin analogues for treatment of type 2 diabetes patients with normal and elevated BMI results in better glycaemic control, less weight gain, smaller increase in insulin requirement and waist circumference compared to human insulins during the first year of insulin therapy.