Use of a reference four-component model to define the effects of insulin treatment on body composition in type 2 diabetes: the 'Darwin study'
| Autor: | W. A. Coward, N. J. Fuller, Nick Finer, I. C. Packianathan, Antony Wright, D. B. Peterson |
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| Rok vydání: | 2004 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism medicine.medical_treatment Body water Type 2 diabetes Weight Gain Models Biological Body Mass Index Internal medicine Diabetes mellitus Internal Medicine Medicine Insulin lispro Humans Hypoglycemic Agents Insulin Prospective Studies Insulin Lispro business.industry Body Weight medicine.disease Endocrinology Adipose Tissue Diabetes Mellitus Type 2 Lean body mass Body Composition medicine.symptom business Body mass index Weight gain medicine.drug |
| Zdroj: | Diabetologia. 48(2) |
| ISSN: | 0012-186X |
| Popis: | To define the effects of insulin treatment on body composition and fat distribution, and investigate the potential role of body weight (BWt) gain predictors in patients with poorly controlled type 2 diabetes.Assessments of body composition, using a four-component model, and biochemical indices were obtained in 19 patients [mean (SD): age, 60 (8.3) years; BMI, 25.3 (3.3) kg/m(2)] with poorly controlled type 2 diabetes, despite maximal oral hypoglycaemic agents, receiving insulin [40 (12.2) units/day] at baseline and after 1, 3 and 6 months.Insulin therapy significantly reduced plasma glucose [-6.0 (4.3) mmol/l], improved [HbA(1)c [-1.9 (1.8)%], and reversed the BWt lost [3.3 (1.8) kg] before treatment. The 6-month BWt gain [+5.2 (2.7) kg] consisted of body fat [+2.9 (2.7) kg] and fat-free mass [FFM; +2.3 (1.8) kg], with the FFM increase due solely to total body water [TBW; +2.4 (1.5) l], as there were no detectable changes in total body protein or bone mineral, thereby increasing FFM hydration by 1.3%. More body fat was deposited centrally in patients receiving insulin alone than those receiving insulin with an oral hypoglycaemic agent (metformin). Daily insulin dose, HbA(1)c and hip circumference were independent predictors of BWt gain.Insulin treatment increased fat and FFM similarly in poorly controlled type 2 diabetes patients, with the FFM gain due entirely to TBW. The possible role of metformin in reducing central fat accumulation following insulin treatment warrants further investigation into its mechanism and potential long-term benefits. |
| Databáze: | OpenAIRE |
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