Weight gain in type 2 diabetics with different treatment modalities

Abstract

Background: The aim of this study was to study (1) weight gain in type 2 diabetics with different treatment modalities and (2) relationship of weight gain with stable adult weight.

Methods: A study of 469 type 2 diabetics on regular follow-up was undertaken to determine the effect of modality of therapy on patient's weight. Stable weight maintained by the patient in good health was ascertained. Weight at visit 1 and subsequently at every follow-up was noted. Patients were grouped as per treatment modality. Weight gain was correlated with pretreatment weight loss, stable weight, and degree of metabolic control.

Results: All treatment subgroups showed a steady upward trend of weight gain at 1-year follow-up. Maximum weight gain was seen in the sulphonylurea and insulin (SU + I) group (mean +/- SD, kg; 2.9 +/- 3.8, p < 0.05) followed by the insulin group (1.8 +/- 4.9), SU group (1.2 +/- 2.9), and SU + metformin (MF) + I group (0.6 +/- 2.8), and was the least in the SU + MF group (0.6 +/- 2.9). Weight gain was not significant, except in SU + I group. Addition of metformin prevented weight gain until 9 months follow-up, but the trend reversed on prolonged follow-up. Most patients tended to move towards their stable body weight. Patients with weight loss in the pre-treatment period (n = 253; weight loss 4.1 +/- 1.6 kg) gained significant weight (4.5 +/- 1.9 kg), while those without significant weight loss in the pre-treatment period (n = 216) did not. Weight gain was significant in the good and fair glycemic control groups, but not so in the poor glycemic control group.

Conclusions: Only the SU + I group gained significant weight. The weight gain on treatment was significantly related to pre-treatment weight loss. Most patients moved towards their stable body weight with improved metabolic control.