Reduced Weight Gain with Insulin Detemir Compared to NPH Insulin Is Not Explained by a Reduction in Hypoglycemia

Davies, Melanie J.; Dereziński, Tadeusz; Pedersen, Carsten; Clauson, Per

doi:10.1089/dia.2008.0282

Cited by 39 publications

(38 citation statements)

References 37 publications

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“…Moreover, Davies et al. 17 analysed weight gain data as a function of hypoglycaemia frequency in insulin‐naïve people with T2D and found no significant relationship between these two outcomes, suggesting that the weight‐sparing effect of insulin detemir must logically involve other mechanisms.…”

Section: Food Intake Modelmentioning

confidence: 99%

Weight‐sparing effect of insulin detemir: a consequence of central nervous system‐mediated reduced energy intake?

Russell‐Jones

Danne

Hermansen

et al. 2015

Diabetes Obesity Metabolism

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Insulin therapy is often associated with adverse weight gain. This is attributable, at least in part, to changes in energy balance and insulin's anabolic effects. Adverse weight gain increases the risk of poor macrovascular outcomes in people with diabetes and should therefore be mitigated if possible. Clinical studies have shown that insulin detemir, a basal insulin analogue, exerts a unique weight‐sparing effect compared with other basal insulins. To understand this property, several hypotheses have been proposed. These explore the interplay of efferent and afferent signals between the muscles, brain, liver, renal and adipose tissues in response to insulin detemir and comparator basal insulins. The following models have been proposed: insulin detemir may reduce food intake through direct or indirect effects on the central nervous system (CNS); it may have favourable actions on hepatic glucose metabolism through a selective effect on the liver, or it may influence fluid homeostasis through renal effects. Studies have consistently shown that insulin detemir reduces energy intake, and moreover, it is clear that this shift in energy balance is not a consequence of reduced hypoglycaemia. CNS effects may be mediated by direct action, by indirect stimulation by peripheral mediators and/or via a more physiological counter‐regulatory response to insulin through restoration of the hepatic–peripheral insulin gradient. Although the precise mechanism remains unclear, it is likely that the weight‐sparing effect of insulin detemir can be explained by a combination of mechanisms. The evidence for each hypothesis is considered in this review.

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Section: Food Intake Modelmentioning

confidence: 99%

Weight‐sparing effect of insulin detemir: a consequence of central nervous system‐mediated reduced energy intake?

Russell‐Jones

Danne

Hermansen

et al. 2015

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

show abstract

“…[13][14][15] Thus, the focus has been on developing type 2 diabetes drugs associated with little or no weight gain. [16][17][18] To develop such treatments, pre-clinical models in which weight gain can be examined are employed. 19 Weight gain, however, affects CVD risk differently depending on its location.…”

Section: Introductionmentioning

confidence: 99%

Effects of insulin therapy on weight gain and fat distribution in the HF/HS-STZ rat model of type 2 diabetes

Skovsø¹,

Damgaard

Fels

et al. 2015

Int J Obes

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“…A post hoc analysis of a randomized controlled treat-totarget trial in 476 insulin-naïve patients with T2D suggested that the reduced weight gain seen with insulin detemir treatment versus NPH insulin is not a result of the reduction in hypoglycemia [13]. Although hypoglycemia was predictive of weight gain with NPH insulin in this study, the same relationship was not found for insulin detemir, suggesting that other mechanisms are responsible for insulin detemir's weight benefit.…”

Section: Long-acting Analoguesmentioning

confidence: 45%

Are Analogue Insulins Superior to Human Insulin in Clinical Practice?

Freeman

2010

Curr Diab Rep

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Insulin analogues were designed to provide more physiologic pharmacokinetic and pharmacodynamic properties compared with human insulin. This article examines the literature over a 2-year period, focusing on studies directly comparing analogue and human insulin in controlled clinical trials and large observational studies documenting the introduction of, or change to, analogue insulin in clinical practice. Findings indicate that analogues provide objective benefits that include improved glycemic control, lower risk of hypoglycemia, lower glucose variability, and (for insulin detemir) reduced weight gain. Recent data with analogues also explore their safety and efficacy in special patient groups such as children and adolescents. These data complement increasing evidence that analogues offer improved acceptability and accessibility to people with diabetes.

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Reduced Weight Gain with Insulin Detemir Compared to NPH Insulin Is Not Explained by a Reduction in Hypoglycemia

Abstract: Hypoglycemia is predictive of weight gain with NPH insulin, but the same relationship is not seen with insulin detemir. It is therefore likely that the weight-sparing effect of insulin detemir involves other mechanisms.

Cited by 39 publications

References 37 publications

Weight‐sparing effect of insulin detemir: a consequence of central nervous system‐mediated reduced energy intake?

Weight‐sparing effect of insulin detemir: a consequence of central nervous system‐mediated reduced energy intake?

Effects of insulin therapy on weight gain and fat distribution in the HF/HS-STZ rat model of type 2 diabetes

Are Analogue Insulins Superior to Human Insulin in Clinical Practice?

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