Is Weight Gain an Unavoidable Consequence of Insulin Therapy?

Weight gain is often a significant concern among patients with type 2 diabetes. Patients using long-acting insulin analogs, particularly insulin detemir, often have decreased weight gain and sometimes even weight loss following treatment, as well as a reduced incidence of hypoglycemia. These benefits may be due in part to the more predictable action profiles associated with long-acting insulin analogs, as compared with the older basal formulations that are based on human insulin. In this review, the properties of basal insulin analogs will be considered as they relate to weight gain, and several strategies to more effectively manage the problem of insulin-associated weight gain will be discussed. CONFLICT OF INTEREST Bruce W. Bode receives grant/research support, participates in the speaker's bureau program, and is a consultant to Eli Lilly, Novo Nordisk, and Sanofi-Aventis. Dr. Bode would like to thank Novo Nordisk for funding that helped support the preparation of this manuscript.