Endocrine Abstracts

Introduction: Insulin therapy ( IT) in type 2 diabetes( T2D) is an integral Pharmacologic Approache because of the progressive nature of the disease. Insulin improves glycemic control and reduces the risk of microvascular complications. It’s however associated with weight gain as a side effect which promotes insulinoresistance and cardiovascular morbi–mortality.

In this work we evaluated long–term weight gain in insulin–treated patients with T2D.

Materials and methods: It was a retrospective, descriptive and longitudinal study includng T2D patients on IT for at least 10 years and monitored at the National Nutrition Institute of Tunis. Demographic and clinico–biological data were extracted from the medical record at the initiation of IT and 10 years after.

Results: There were 27 women and 17 men with mean age of 47.7 years old . The average duration of diabetes was 10.78 ± 7.5 years The majority of patients (77.3%) had uncontrolled diabetes with a mean glycated hemoglobin of 9.5 ± 2%. Half of our diabetics were under combination of insulin and oral antidiabetic drugs, 25% with metformin and 20.5% with sulfonylureas. Nearly the a third (38.1%) were on a full basal bolus regimen. Obesity was objectived in 50% of the patients at insulin intiation. the mean initial body mass index (BMI) was 30.65 kg / m², with an extreme ranging from 20.9 to 41.4 kg/m. After 10 years of follow–up, 79.9% of patients had unbalanced diabetes. The average weight gain was 2.21 ± 0.8 kg. The mean BMI was 31.14 kg / m² with a statistically significant difference (P < 0.001) compared to the time of insulin intiation.

Conclusions: Weight gain remains a classic side effect of insulin therapy. However, it can be limited by increasing physical activity, calorie intake restriction and concomitant metformin administration.