Potential causes of weight gain in type 1 diabetes mellitus

A. N. Jacob, K. Salinas, Beverley A Huet, Philip Raskin

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

Aim: To investigate the potential causes of weight gain with insulin therapy and improved diabetic control in type 1 diabetes mellitus. Methods: This was an open-label prospective study of insulin therapy of 6months duration in an academic medical centre. Twenty-one subjects with type 1 diabetes were enrolled. The goal was to achieve an haemoglobin A1c (HbA1c) in the range of individuals without diabetes (<5.6%). At baseline, 3 and 6months, weight, resting energy expenditure, appetite assessment, food intake, activity level, HbA1c and 24-h glycosuria and urea nitrogen were measured. Plasma leptin, ghrelin and adiponectin levels and body fat were measured at baseline and 6months. Results: At baseline, average weight was 73.7 ± 17.4kg and HbA1c was 10.0 ± 2.2%. Weight increased by 2.15kg (2.69% of baseline) by 6months whereas the HbA1c dropped by 1.71% (16.3%) to 7.9%. Energy intake differences between 3 and 6months had a negative correlation with weight gain, but the changes in glycosuria, appetite scores and the frequency of hypoglycaemia did not correlate with weight gain. Glycaemic control did not correlate with weight change but tended to correlate with fat mass increase (p = 0.064; r = -0.51). An increase in the activity levels between 3 and 6months correlated with decreasing fat mass (p = 0.037; r = -0.74). The changes in the appetite scores had a negative correlation with fat mass gain (p = 0.035; r = -0.61). The changes in lean body mass correlated with protein and total energy intake (p = 0.007, r = 0.85 and p = 0.003, r = 0.73 respectively). The changes in leptin levels correlated with weight gain. Conclusions: The lipogenic effect of insulin with subsequent increase in fat mass may be the primary cause of this weight gain that can be attenuated by the increases in the activity levels. The negative correlation of energy intake and appetite scores with fat mass gain suggests that they do not play a significant role in fat mass gain whereas energy intake did correlate with lean body mass gain.

Original languageEnglish (US)
Pages (from-to)404-411
Number of pages8
JournalDiabetes, Obesity and Metabolism
Volume8
Issue number4
DOIs
StatePublished - Jul 2006

Keywords

  • Ghrelin
  • Insulin therapy
  • Type1 diabetes
  • Weight gain

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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