Effect of insulin treatment on the body composition of Type 2 diabetic patients

Sallé, Agnès; Guilloteau, G.; Ryan, Mary Morgan; Bouhanick, Béatrice; Ritz, Patrick

doi:10.1111/j.1464-5491.2004.01335.x

Cited by 27 publications

(19 citation statements)

References 27 publications

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“…Weight was measured before breakfast, in undergarments, on plethysmographic weighing scales, calibrated prior to each test to the nearest 0.01 kg. Percentage of fat and fat-free mass was determined using a three-compartment model as described previously [32]. Measurements of body volume were performed by air displacement plethysmography, and total body water was estimated using bioelectrical impedance.…”

Section: Body Compositionmentioning

confidence: 99%

Zinc Deficiency: A Frequent and Underestimated Complication After Bariatric Surgery

Sallé

Demarsy

Poirier³

et al. 2010

OBES SURG

109

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Section: Body Compositionmentioning

confidence: 99%

Zinc Deficiency: A Frequent and Underestimated Complication After Bariatric Surgery

Sallé

Demarsy

Poirier³

et al. 2010

OBES SURG

109

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“…6,[87][88][89] Weight gain in type 2 patients occurs through increases in both fat and fat-free mass. 88,89 In the DCCT, even modest weight increases had a negative impact on lipid profiles and systolic blood pressure. 90 Similar findings in type 2 patients were noted in a report from the Swedish National Diabetes Register.…”

Section: Weight Gainmentioning

confidence: 99%

Insulin Analogs: Impact on Treatment Success, Satisfaction, Quality of Life, and Adherence

Hartman

2008

Clinical Medicine & Research

116

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Despi te 85 years of research since Banting and Best's isolation of insulin-containing extracts, 1 diabetes still remains one of the most significant causes of morbidity and mortality in the world, and its global impact is likely to accelerate over the coming decades. 2,3 Much of the medical and economic consequences of diabetes are attributable to its associated microvascular and macrovascular complications. [4][5][6] Two classic large-scale clinical studies, the Diabetes Control and Complications Trial (DCCT) 6 and the UK Prospective Diabetes Study (UKPDS), 7 demonstrated that intensive blood-glucose control policies can decrease the frequency of complications, arguing that physicians and patients should strive to mimic, as closely as possible, the serum levels of insulin produced by a healthy person. Secretion of insulin by the pancreas, however, is under complex regulation that depends on the intake of nutrients, other gastrointestinal peptides (e.g., incretins), and overall metabolic levels (i.e., exercise versus rest). 8 These physiological variables, which pose real challenges to the accurate metabolic replacement of insulin, are further complicated by the fact that diabetes requires self-management and therefore depends on the psychology, motivation, and understanding of the patient. A growing body of medical research has demonstrated that intensive control of serum glucose levels can minimize the development of diabetes-related complications. Success with insulin management ultimately depends on how closely a given regimen can mimic normal physiologic insulin release patterns.The new insulin analogs, including the rapid-acting analogs (aspart, lispro, glulisine), the long-acting basal analogs (glargine, detemir), and the premixed insulin analog formulations (75% neutral protamine lispro, 25% lispro; 50% neutral protamine lispro, 50% lispro; 70% protamine aspart, 30% aspart) have been formulated to allow for a closer replication of a normal insulin profile.The rapid-acting analogs can be administered at mealtimes and produce a rapid and short-lived insulin spike to address postprandial glucose elevations, while the long-acting analogs come close to the ideal of a smooth, relatively flat, 24-hour basal insulin supply, with less variability in action compared to NPH insulin. Despite these clear pharmacologic advantages, measurable clinical benefits in a complex disease such as diabetes can be hard to measure.To date, reviews of insulin analog studies have not found a dramatic overall improvement in glycosylated hemoglobin (HbA1c) outcomes compared to traditional human insulins, although all-analog basal-bolus regimens were associated with significantly lower HbA1c than all-human-insulin basal bolus regimens in some studies. Beyond HbA1c comparisons, however, insulin analogs have been shown in many instances to be associated with lower risks of hypoglycemia, lower levels of postprandial glucose excursions, better patient adherence, greater quality of life, and higher satisfaction with treatment.The long-act...

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“…Body composition was affected by the fl uctuations of body hydration. 14 The bone mass was higher in diabetics than in controls: it had low statistical signifi cance in the age group of 61-80 years while in the other age group it was high but failed to reach statistical signifi cance. Strotmeyer et al 15 also reported higher bone mass in diabetic patients compared with that of non-diabetics.…”

Section: Discussionmentioning

confidence: 88%

Assessment of Body Composition of Male Patients with Type 2 Diabetes by Bioelectrical Impedance Analysis

Baltadjiev

Baltadjiev²

2011

Folia Medica

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INTRODUCTION: Type 2 diabetes is a metabolic disorder and as such should affect the components of body composition of diabetics. The changes it induces in patients complement the anthropological characteristics of this disease. The AIM of the present study was to assess the effect type 2 diabetes has on some of the body composition components in male diabetics. MATERIAL AND METHODS: The study included 169 male patients with type 2 diabetes. All patients (ethnical Bulgarian) were allocated into two age groups: group 1 -patients aged 40-60 years and group 2 -patients aged 61-80 years. Direct measurements of parameters were performed with a Tanita body composition analyser. The bioimpedance parameters we measured were body fat percentage (%BF), total body water percentage (%ТВW), muscle mass (ММ), bone mass (BМ), and visceral fat (VF). The derived parameters were total body fat (ТBF) (kg), active body mass (АBМ) (kg), active body mass percentage. RESULTS: Body composition of male diabetics aged 40-60 years: %BF, VF and TBF were statistically signifi cantly higher in diabetics than in healthy controls. Body composition of male diabetic patients aged 61-80 years: BM and VF were signifi cantly higher in diabetic patients than in controls. %BF and MM did not have a high statistical signifi cance. Interage comparison of body composition in male diabetics: we found that %BF, %TBW, MM and BM tend to be higher in 40-60-year-olds. Visceral fat was increased in the 61-80-yearolds, the difference reaching high statistical signifi cance. CONCLUSION: Bioimpedance analysis (BIA) of body composition showed the total body fat in male diabetics of both age groups to be greater than that in controls. TBF was greater in the younger age group at the expense of the subcutaneous fat, while in the more elderly patients it was the visceral fat that was increased, which makes their body composition correlate rather adversely with the prognosis, course and outcome of the disease. The relative percentage of active body mass was greater in the healthy individuals than in diabetic patients. This parameter was higher in the younger age group of diabetic patients than in the more elderly patients; this fi nding is probably due to the longer duration of the disease and also to aging changes such as osteoporosis, muscle atrophy and decreased quantities of body water.

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Effect of insulin treatment on the body composition of Type 2 diabetic patients

Abstract: Over 6 months, insulin therapy leads to a weight gain of 1.7 kg because of an increase in both fat and fat-free mass. When body composition is determined by bioelectrical impedance analysis, the results are biased by fluctuations in hydration.

Cited by 27 publications

References 27 publications

Zinc Deficiency: A Frequent and Underestimated Complication After Bariatric Surgery

Zinc Deficiency: A Frequent and Underestimated Complication After Bariatric Surgery

Insulin Analogs: Impact on Treatment Success, Satisfaction, Quality of Life, and Adherence

Assessment of Body Composition of Male Patients with Type 2 Diabetes by Bioelectrical Impedance Analysis

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