Cardiovascular Outcomes With Insulin-Induced Weight Gain in T2D
Patients who experienced weight loss experienced a greater number of adverse CV-related outcomes compared with those with insulin-induced weight gain.
Weight gain associated with insulin therapy is not associated with adverse cardiovascular outcomes or risk for mortality in people with type 2 diabetes, according to study findings presented in Diabetes/Metabolism Research and Reviews.
Patients were categorized into 5 groups: >5 kg weight loss,1.0 to 5.0 kg weight loss, no change in weight, 1.0 to 5.0 kg weight gain, and >5.0 kg weight gain.
There was a significant difference within the weight-change categories with regard to the 5-year probability of survival (log‐rank test P =.0005). A total of 1963 composite events, including all‐cause mortality, nonfatal myocardial infarction, or nonfatal stroke, occurred in the entire cohort.
There was a 31% greater risk for composite events in the group who experienced a >5 kg loss in weight compared with patients who experienced no weight change (adjusted hazard ratio [aHR]: 1.31; 95% CI, 1.02-1.68). Among obese participants, risk for the composite end points was 50% greater in the group who lost <5 kg compared with patients who did not lose weight (aHR: 1.50; 95% CI, 1.08‐2.08). Overall, patients who experienced weight loss experienced a greater number of adverse cardiovascular-related outcomes compared with those who experienced insulin-induced weight gain or no weight change.
The investigators are unsure whether or not participants in this study adhered to their medication routine. Additionally, unadjusted lifestyle and dietary factors could have influenced the results, further limiting the clinical relevance of the findings.
Because many people with type 2 diabetes are concerned with the effects of therapy-related weight gain, the investigators comment that the study findings, “should provide important reassurance among patients with type 2 diabetes who gained weight following insulin treatment in routine clinical practice.”
Anyanwagu U, Mamza J, Donnelly R, Idris I. Association between insulin-induced weight change and CVD mortality: evidence from a historic cohort study of 18,814 patients in UK primary care [published online September 2, 2017]. Diabetes Metab Res Rev. doi:10.1002/dmrr.2945