PMID- 37196706
OWN - NLM
STAT- MEDLINE
DCOM- 20230606
LR  - 20230606
IS  - 1872-8227 (Electronic)
IS  - 0168-8227 (Linking)
VI  - 200
DP  - 2023 Jun
TI  - Determinants of excessive weight gain after the initiation of insulin therapy in 
      type 2 diabetes mellitus: Retrospective inception cohort study (ZODIAC 60).
PG  - 110719
LID - S0168-8227(23)00482-5 [pii]
LID - 10.1016/j.diabres.2023.110719 [doi]
AB  - AIMS: To explore determinants of excessive weight gain after initiation of 
      insulin therapy in type 2 diabetes mellitus (T2DM), in particular variables 
      identified in the pre-insulin phase. METHODS: We performed a retrospective 
      observational intervention cohort study, by means of a new user design/ inception 
      cohort concerning n = 5086 patients. We studied determinants of excessive weight 
      gain (5 kg or more) in the first year after initiation of insulin therapy, using 
      both visualization and logistic regression analysis with subsequent receiver 
      operation characteristic (ROC) analyses. Potential determinants pre-, at- and 
      post-insulin initiation were included. RESULTS: One out of 10 patients (10.0%) 
      gained 5 kg weight or more. The earliest determinants of excessive weight gain 
      were weight change (inversely) and HbA1c change in the two years prior to insulin 
      therapy (p < 0.001). Patients that lost weight parallel with HbA1c rise in the 
      two-years pre-insulin, showed the most pronounced weight gain. Of these patients, 
      roughly one out of five (20.3%) gained 5 kg weight or more. CONCLUSIONS: 
      Clinicians and patients should be alert for excessive weight gain after 
      initiation of insulin, in the case of weight loss prior to insulin therapy 
      initiation, particularly with increasing and prolonged high HbA1c at (and after) 
      insulin initiation.
CI  - Copyright (c) 2023 The Authors. Published by Elsevier B.V. All rights reserved.
FAU - Edens, Mireille A
AU  - Edens MA
AD  - Diabetes Research Center, Dokter van Deenweg 1, 8025 BP Zwolle, the Netherlands; 
      Epidemiology Unit, Department Innovation and Science, Isala Hospital, Dokter van 
      Deenweg 1, 8025 BP Zwolle, the Netherlands. Electronic address: 
      m.a.edens@isala.nl.
FAU - van Dijk, Peter R
AU  - van Dijk PR
AD  - Diabetes Research Center, Dokter van Deenweg 1, 8025 BP Zwolle, the Netherlands; 
      Department of Endocrinology, University of Groningen and University Medical 
      Center Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands. Electronic 
      address: p.r.van.dijk@umcg.nl.
FAU - Hak, Eelko
AU  - Hak E
AD  - Groningen Research Institute of Pharmacy, University of Groningen, Antonius 
      Deusinglaan 1, 9713 AV Groningen, the Netherlands. Electronic address: 
      e.hak@rug.nl.
FAU - Bilo, Henk J G
AU  - Bilo HJG
AD  - Diabetes Research Center, Dokter van Deenweg 1, 8025 BP Zwolle, the Netherlands; 
      Department of Internal Medicine, University of Groningen and University Medical 
      Center Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands. Electronic 
      address: h.j.g.bilo@isala.nl.
LA  - eng
PT  - Journal Article
DEP - 20230519
PL  - Ireland
TA  - Diabetes Res Clin Pract
JT  - Diabetes research and clinical practice
JID - 8508335
RN  - 0 (Insulin)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Glycated Hemoglobin)
RN  - 0 (Insulin, Regular, Human)
SB  - IM
MH  - Humans
MH  - *Insulin/adverse effects
MH  - *Diabetes Mellitus, Type 2/drug therapy/chemically induced
MH  - Hypoglycemic Agents/adverse effects
MH  - Glycated Hemoglobin
MH  - Cohort Studies
MH  - Retrospective Studies
MH  - Weight Gain
MH  - Insulin, Regular, Human
OTO - NOTNLM
OT  - Body weight
OT  - Insulin therapy
OT  - Type 2 diabetes mellitus
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/05/18 01:07
MHDA- 2023/06/06 06:42
CRDT- 2023/05/17 19:23
PHST- 2023/02/16 00:00 [received]
PHST- 2023/04/20 00:00 [revised]
PHST- 2023/05/11 00:00 [accepted]
PHST- 2023/06/06 06:42 [medline]
PHST- 2023/05/18 01:07 [pubmed]
PHST- 2023/05/17 19:23 [entrez]
AID - S0168-8227(23)00482-5 [pii]
AID - 10.1016/j.diabres.2023.110719 [doi]
PST - ppublish
SO  - Diabetes Res Clin Pract. 2023 Jun;200:110719. doi: 10.1016/j.diabres.2023.110719. 
      Epub 2023 May 19.