Objective: The goal of this study, of type 2 diabetes mellitus patients, treated in a referral community setting, was to follow the history of weight changes, in relation to the changing treatment modalities, and to detect independent risk factor and predictors for weight gain.
Research methods: 366 outpatients with type 2 diabetes (T2DM) were followed longitudinally for at least 5 years. 310 patients were treated with oral hypoglycemic agents and 56 patients had insulin treatment added to the oral therapy.
Results: The two groups did no differ significantly in the duration of diabetes, age of onset and admission HbA1c. The mean weight at admission was 78.9+/-15.1 and 76.7+/-15.0 kg (ns) respectively. No significant weight changes were noted on initiation of oral treatment and at final visit. The commencing of insulin therapy was the only step associated with a significant 3.7 kg increase in body weight (p<0.001) with a significant reduction in HbA1c (-1.4%, p<0.001). These changes however, followed a decrease in body weight that preceded insulin therapy. Mean weight at follow-up did not exceed the self-reported weight prior to the diagnosis of diabetes.
Discussion: The results show that weight gain does not necessarily accompany treatment of T2DM. Insulin therapy in T2DM is associated with some weight gain, mostly due to correction of glycemia and improvement of weight loss prior to insulin treatment. This should encourage the timely addition and combining of appropriate therapeutic modalities in order to achieve good glycemic control.