Abstract
Objective: In individuals with type 2 diabetes, weight gain during treatment with insulin and other agents prevents the attainment of glycemic targets and probably limits the success of treatment. Studies have attempted to elucidate the mechanisms behind the apparent paradox of insulin improving glycemic control and cardiovascular risks, white causing weight gain. The aim of this study is to clarify the influence of insulin therapy on body weight and differential fat distribution (visceral or peripheral) in newly insulin treated type 2 diabetic mate patients.
Patients and Methods: The study was conducted on 26 type 2 diabetic mate patients evaluated at baseline and 12 months after instituting insulin therapy. Body mass index (BMI), absolute waist circumference (AWC), systolic and diastolic blood pressure, HbA1c% were estimated. Abdominal Computed tomography was applied to evaluate areas of subcutaneous fat (SF) and visceral fat (VF) before and after insulin therapy.
Results: There is significant reduction in HbA1c (9.03 +/- 0.72 vs. 7.50 +/- 0.58, p<0.001) and significant increase body mass index (BMI =28.92 +/- 1.39 vs. 29.81 +/- 1.27, p=0.02) However there was non significant changes in the AWC 103.27 +/- 3.87 Vs 105.14 +/- 3.25, P=0.065, VF 121.01 +/- 5.84 Vs 123.01 +/- 5.55, p=0.213, SF 206.54 +/- 9.93 Vs 212.12 +/- 11.62, P = 0.069 and V/S ratio 0.59 +/- 0.03 vs. 0.58 +/- 0.03, P=0.365.
Conclusion: Weight gain in the newly insulin treated type 2 diabetic patients during 12 months duration is equally distributed in both peripheral and visceral fat. So, insulin therapy does not appear to increase the visceral fat in type 2 diabetic patients which is strongly liked to atherosclerosis. Longer-term follow up and bigger sample size are necessary to address the issue of the kinetics of weight gain and to establish the possible correlation with other cardiovascular risk markers.