Open AccessPrediction of excessive weight gain in insulin treated patients with type 2 diabetes
Author(s) -
Cichosz Simon Lebech,
LundbyChristensen Louise,
Johansen Mette D.,
Tarnow Lise,
Almdal Thomas Peter,
Hejlesen Ole K.,
Group The C.I.M.T. Trial
Publication year - 2017
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.12418
Subject(s) - weight gain , medicine , quartile , insulin , receiver operating characteristic , type 2 diabetes , weight change , metformin , diabetes mellitus , weight loss , endocrinology , body weight , confidence interval , obesity
Background Weight gain is an ongoing challenge when initiating insulin therapy in patients with type 2 diabetes mellitus (T2DM). However, if prediction of insulin‐associated weight gain was possible on an individual level, targeted initiatives could be implemented to reduce weight gain. The aim of the present study was to identify predictors of weight gain in insulin‐treated patients with T2DM. Methods In all, 412 individuals with T2DM were, in addition to metformin or placebo, randomized into 18‐month treatment groups with three different insulin analog treatment regimens (biphasic, aspart, detemir). Participants with excessive weight gain were defined as the group with weight gain in the 4th quartile (>6.2 kg).We developed a pattern classification method to predict individuals prone to excessive weight gain. Results Over the 18‐month treatment period, median weight gain among all 412 patients was 2.4 kg (95% prediction interval [PI] –5.6, 12.4 kg), whereas median weight gain for those in the upper 4th quartile (n = 103) was 8.9 kg (95% PI 6.3, 15.2 kg). No clinical baseline data were strong predictors of excessive weight gain. However, the weight gain during the first 3 months of the trial and the subsequent dose of insulin yielded a useful predictor for weight gain at the 18‐month follow‐up. Combining these two predictors into a prediction model with other clinical available information produced a receiver operating characteristic area under the curve of 0.80. Conclusions We have developed a prediction model that could help identify a substantial proportion of individuals with T2DM prone to large weight gain during insulin therapy.