Cerebral Blood Flow and Glucose Metabolism in Appetite-Related Brain Regions in Type 1 Diabetic Patients After Treatment With Insulin Detemir and NPH Insulin

Autor: Madeleine L. Drent, Richard G. IJzerman, Marc C. Huisman, J.F. Hensbergen, Adriaan A. Lammertsma, M. Diamant, L.W. van Golen, Roel P.L.M. Hoogma
Rok vydání: 2013
Předmět:
Male
endocrine system diseases
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Insulin
Isophane
Appetite
NPH insulin
0302 clinical medicine
Insulin Detemir
Medicine
Original Research
Insulin detemir
Cross-Over Studies
Brain
Middle Aged
Magnetic Resonance Imaging
Insulin
Long-Acting
Cerebral blood flow
Cerebrovascular Circulation
Female
medicine.drug
Adult
medicine.medical_specialty
Adolescent
030209 endocrinology & metabolism
Carbohydrate metabolism
Young Adult
03 medical and health sciences
Imaging
Three-Dimensional
Internal medicine
Diabetes mellitus
Internal Medicine
Humans
Hypoglycemic Agents
Pathophysiology/Complications
Retrospective Studies
Advanced and Specialized Nursing
Type 1 diabetes
business.industry
Insulin
nutritional and metabolic diseases
medicine.disease
Crossover study
Diabetes Mellitus
Type 1
Glucose
Endocrinology
Regional Blood Flow
business
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: Diabetes Care
ISSN: 1935-5548
0149-5992
DOI: 10.2337/dc13-0093
Popis: OBJECTIVE To test the hypothesis that insulin detemir, which is associated with less weight gain than other basal insulin formulations, exerts its weight-modulating effects by acting on brain regions involved in appetite regulation, as represented by altered cerebral blood flow (CBF) or cerebral glucose metabolism (CMRglu). RESEARCH DESIGN AND METHODS Twenty-eight male type 1 diabetic patients (age 36.9 ± 9.7 years, BMI 24.9 ± 2.7 kg/m2, A1C 7.5 ± 0.6%) successfully completed a randomized crossover study, consisting of two periods of 12-week treatment with either insulin detemir or NPH insulin, both in combination with prandial insulin aspart. After each treatment period, patients underwent positron emission tomography scans to measure regional CBF and CMRglu. RESULTS After 12 weeks, A1C, daily insulin doses, fasting insulin, and blood glucose levels were similar between treatments. Insulin detemir resulted in body weight loss, whereas NPH insulin induced weight gain (between-treatment difference 1.3 kg; P = 0.02). After treatment with insulin detemir relative to NPH insulin, CBF was higher in brain regions involved in appetite regulation, whereas no significant difference in CMRglu was observed. CONCLUSIONS Treatment with insulin detemir versus NPH insulin resulted in weight loss, paralleled by increased CBF in appetite-related brain regions in the resting state, in men with well-controlled type 1 diabetes. These findings lend support to the hypothesis that a differential effect on the brain may contribute to the consistently observed weight-sparing effect of insulin detemir.
Databáze: OpenAIRE
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