{"title":"At last, a weight neutral insulin?","authors":"A Fritsche,&nbsp;H Häring","doi":"10.1038/sj.ijo.0802749","DOIUrl":null,"url":null,"abstract":"<p><p>In the treatment of diabetes, the positive correlation between weight gain and glycaemic control is well known. Inappropriate weight gain has been demonstrated in landmark diabetes studies, with insulin or oral antidiabetic drugs. Weight increase is associated with accelerated deterioration in beta-cell function in type II diabetes, and increases in hypertension and lipid levels in both type I and type II diabetes. Concerns about increasing weight may be a barrier to initiation or to intensification of insulin therapy. Insulin introduction may be delayed in type II diabetes, and patients may under-dose their insulin to avoid gaining weight. Insulin detemir is a new long-acting soluble insulin analogue where protraction is achieved by reversible binding to albumin. As a result, it has consistent absorption and low variability from injection to injection. Studies of insulin detemir in basal-bolus regimens in type I and type II diabetes have shown significantly less weight gain compared with NPH. There is speculation about potential mechanisms for these outcomes and results from ongoing investigations are awaited. The insulin detemir data suggest that weight gain with insulin therapy is not inevitable. The potential therefore exists for improving glycaemic control while maintaining weight stability, resulting in immediate and long-term benefits for patients.</p>","PeriodicalId":14227,"journal":{"name":"International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2004-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1038/sj.ijo.0802749","citationCount":"72","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1038/sj.ijo.0802749","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 72

Abstract

In the treatment of diabetes, the positive correlation between weight gain and glycaemic control is well known. Inappropriate weight gain has been demonstrated in landmark diabetes studies, with insulin or oral antidiabetic drugs. Weight increase is associated with accelerated deterioration in beta-cell function in type II diabetes, and increases in hypertension and lipid levels in both type I and type II diabetes. Concerns about increasing weight may be a barrier to initiation or to intensification of insulin therapy. Insulin introduction may be delayed in type II diabetes, and patients may under-dose their insulin to avoid gaining weight. Insulin detemir is a new long-acting soluble insulin analogue where protraction is achieved by reversible binding to albumin. As a result, it has consistent absorption and low variability from injection to injection. Studies of insulin detemir in basal-bolus regimens in type I and type II diabetes have shown significantly less weight gain compared with NPH. There is speculation about potential mechanisms for these outcomes and results from ongoing investigations are awaited. The insulin detemir data suggest that weight gain with insulin therapy is not inevitable. The potential therefore exists for improving glycaemic control while maintaining weight stability, resulting in immediate and long-term benefits for patients.

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最终,一种体重中性胰岛素?
在糖尿病的治疗中,体重增加与血糖控制之间的正相关是众所周知的。在具有里程碑意义的糖尿病研究中,胰岛素或口服降糖药已证实不适当的体重增加。体重增加与II型糖尿病β细胞功能加速恶化有关,与I型和II型糖尿病高血压和脂质水平升高有关。对体重增加的担忧可能成为胰岛素治疗开始或强化的障碍。II型糖尿病患者可能会延迟胰岛素的引入,并且患者可能会减少胰岛素剂量以避免体重增加。地特胰岛素是一种新的长效可溶性胰岛素类似物,通过与白蛋白的可逆结合实现延长。因此,它具有一致的吸收和低变异性从注射到注射。研究表明,1型和2型糖尿病患者在基础注射方案中,与NPH相比,体重增加明显减少。人们对这些结果的潜在机制进行了推测,正在进行的调查正在等待结果。测定胰岛素的数据表明,胰岛素治疗后体重增加并非不可避免。因此,有可能在保持体重稳定的同时改善血糖控制,从而为患者带来即时和长期的益处。
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