Endocrine Abstracts

Introduction

Weight gain represents a considerable challenge in type 2 diabetes mellitus patients with insulin therapy and a frequent cause of delay in initiation of treatment with insulin. The aim of our study was to describe the features of diabetic obese patient when switching to insulin therapy.

Methods

It was a retrospective study which enrolled 61 patients with type 2 diabetes divided in two groups: patients with a normal Body Mass Index (BMI) < 25 kg/m² and obese patients with BMI b 30 kg/m². All patients were on oral hypoglycemic medications and were admitted in our department to switch to insulin therapy.

Results

In obese patients’ group: the mean age was 55.5 ± 8.2 years, the duration of diabetes was meanly 8.2 ± 5.6 years, the mean initial weight was 84.3 kg ± 10.1 and the mean glycated hemoglobin was 10.4% ± 1.96. In the other group, the mean age was 60.6 ± 8.2 years, the duration of diabetes was meanly 10.6 ± 7.1 years, the mean initial weight was 60.8 kg ± 7.33 and the mean glycated haemoglobin was 11.6% ± 2.1. Hypertension and dyslipidemia were more frequent in the obese patients’ group (74% and 71% respectively). These two comorbidities were found in half of patients with BMI < 25 kg/m². Polymedication were more frequent among obese patients (71% vs 36.7%). Obese patients were receiving lower dose of insulin than normal weighted patients (0.35 UI/kg ± 0.13 VS 0.43 UI/kg ± 0.16). Weight gain was smaller in obese patients compared to the other group (4.55 kg ± 8.7 vs 8.77 kg ± 12.06).

Conclusion

Earlier and lower doses of insulin therapy was indicated in obese patients while weight gain was less noticed in this population. Weigh control and lifestyle intervention are needed for optimal diabetes control especially for obese patients.