Initiation of once daily insulin detemir is not associated with weight gain in patients with type 2 diabetes mellitus: results from an observational study

• Published in: Diabetology and metabolic syndrome Vol. 5; no. 1; p. 56
• Main Authors: Yale, Jean-François, Damci, Taner, Kaiser, Marcel, Karnieli, Eddy, Khunti, Kamlesh, Liebl, Andreas, Baeres, Florian Mm, Svendsen, Anne Louise, Ross, Stuart A
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 02.10.2013; BioMed Central
• Subjects: Body mass index; Complications and side effects; Diabetes; Dosage and administration; Glucose; Glycosylated hemoglobin; Health aspects; Insulin; Insulin detemir; Insulin resistance; Obesity; Pharmaceutical industry; Type 2 diabetes; France; United States; United Kingdom; Canada; Turkey; United Kingdom > UK; China; Poland; Italy; Israel; Portugal; Germany; Spain
• ISSN: 1758-5996; 1758-5996
• DOI: 10.1186/1758-5996-5-56

Obesity is common in type 2 diabetes (T2DM) and is associated with increased risk of morbidity and all-cause mortality. This analysis describes weight changes associated with insulin detemir initiation in real-life clinical practice. Study of Once-Daily Levemir (SOLVE) was a 24-week international observational study of once-daily insulin detemir as add-on therapy in patients with T2DM receiving oral hypoglycaemic agents (OHAs). 17,374 participants were included in the analysis: mean age 62 ± 12 years; weight 80.8 ± 17.6 kg; body mass index (BMI) 29.2 ± 5.3 kg/m2; diabetes duration 10 ± 7 years; HbA1c 8.9 ± 1.6%. HbA1c decreased by 1.3 ± 1.5% during the study, with insulin doses of 0.27 ± 0.17 IU/kg. Patients with higher BMI had higher pre-insulin HbA1c, and similar reductions in HbA1c with insulin therapy. Weight decreased from 80.8 ± 17.6 kg to 80.3 ± 17.0 kg (change of -0.6 [95% CI -0.65; -0.47] kg), with 35% of patients losing >1 kg. Patients with the highest pre-insulin BMI lost the greatest amount of weight: BMI < 25: +0.8 [95% CI: 0.6; 0.9] kg, 25 ≤ BMI < 30: -0.2 [95% CI: -0.3; -0.8] kg, 30 ≤ BMI < 35: -1.0 [95% CI: -1.1; -0.8] kg; BMI ≥ 35: -1.9 [95% CI: -2.2; -1.6] kg. Minor hypoglycaemia decreased with increasing BMI: 2.3 and 1.3 events per patient year for BMI <25 and  ≥ 35, respectively. Overall, patients with poorly controlled T2DM achieved significant reductions in HbA1c after initiation of once-daily insulin detemir therapy, without weight gain. The favourable impact of insulin detemir on weight may not apply to other insulin preparations. ClinicalTrials.gov, NCT00825643 and NCT00740519.