• Obesity
• Diabetes & Endocrinology Clinical Trials
• Diabetes Mellitus
• Insulin

Insulin therapy is an effective method of reducing blood glucose levels and may reduce the risk of cardiovascular disease (CVD) in individuals with type 2 diabetes mellitus (T2DM); however, weight gain is not unusual after initiation of insulin therapy. Beverley Balkau, PhD, INSERM, Villejuif, France, discussed the factors that are predictive of weight gain in the CREDIT study: Cardiovascular Risk Evaluation in people with Type 2 Diabetes on Insulin Therapy.

The CREDIT study is a multinational (North America, Europe, and Asia) observational study that is evaluating the relationship between blood glucose control and cardiovascular (CV) events in individuals with T2DM who have been newly treated with insulin. The study included 2442 men and women aged >40 years with a diagnosis of T2DM who recently started insulin therapy (≤12 months). They were recruited from 314 centers in 12 countries. Follow-up will occur over a 4-year period with no fixed study visit schedule.

People in the CREDIT study gained a median of 1.6 kg one year after starting insulin therapy. The strongest predictor of weight gain was the daily insulin dose at one year, independent of baseline body mass index (BMI) and glucose levels (HbA1C). High baseline BMI was associated with less weight gain, while high baseline HbA1C and tritherapy with oral agents were associated with weight gain, even after controlling for insulin dose (Figure 1). Thus, “baseline obesity should not be an impediment for appropriate insulin treatment,” concluded Dr. Balkau.

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Figure 1.

Factors Predictive of Weight Gain ≥1.6 kg.

Reproduced with permission from B. Balkau, PhD.

Characteristics of patients at the start of insulin therapy and after 1 year are shown in Tables 1a and 1b, while medical history at the start of insulin therapy is shown in Table 2.

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