Effect of insulin therapy on plasma leptin and body weight in patients with type 2 diabetes.

Abstract

AIMS:

This study set out to define relationships between changes in plasma leptin and changes in body weight, plasma insulin and blood glucose control during a 12-month crossover study of once-daily Ultratard or twice-daily Insulatard insulin.

PATIENTS AND METHODS:

Fasting plasma leptin and insulin were measured during a multicentre cross-over study involving 60 subjects with type 2 diabetes (fasting glucose > 8 mM). After a 2-month run-in, there were two 6-month periods of treatment with Insulatard or Ultratard insulin.

RESULTS:

Mean plasma leptin increased significantly in both groups after insulin therapy was instigated (12.8 +/- 8.1 to 22.9 +/- 13.1 ng/ml in the Insulatard group; 12.1 +/- 7.2 to 19.2 +/- 12.3 ng/ml in the Ultratard group). Weight also increased significantly in both groups (82.4 +/- 14.3 kg to 88.8 +/- 14.3 kg and 82.2 +/- 15.3 kg to 85.3 +/- 15.2 kg respectively). The increase in plasma leptin correlated well with the increase in weight (R = 0.416, p = 0.001), and this correlation continued after the crossover point. Plasma leptin correlated with BMI throughout the study (R = 0.540, p = 0.000).

CONCLUSION:

The sustained rise in body weight despite a substantial increase in plasma leptin suggests that either resistance to the hypothalamic action of leptin develops when insulin therapy is begun in type 2 diabetes, or that resetting of the set point for body weight occurs such that a larger body mass is tolerated for a given level of plasma leptin.

• Authors: P E Carey, M W Stewart, L Ashworth, R Taylor
• Journal: Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme (Horm Metab Res) Vol. 35 Issue 6 Pg. 372-6 (Jun 2003) ISSN: 0018-5043 [Print] Germany
• PMID: 12920661 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Glycated Hemoglobin A
• Insulin
• Insulin, Long-Acting
• Insulin, Regular, Human
• Insulin, Ultratard
• Isophane Insulin, Human
• Leptin
• Insulin, Isophane

Topics

• Body Mass Index
• Body Weight
• Cross-Over Studies
• Diabetes Mellitus, Type 2 (drug therapy, physiopathology)
• Fasting
• Female
• Glycated Hemoglobin (analysis)
• Humans
• Insulin (blood)
• Insulin, Isophane
• Insulin, Long-Acting (therapeutic use)
• Insulin, Regular, Human
• Isophane Insulin, Human
• Leptin (blood)
• Male
• Middle Aged