Waist circumference reduction after insulin detemir therapy in type 2 diabetes patients previously treated with NPH

Background and aims: Abdominal weight may increase vascular complication risk. Insulin detemir reduces weight gain in comparison with NPH and insulin glargine. We studied the weight-sparing effect of detemir and assessed glycemic control and treatment satisfaction when switching from NPH to detemir, to improve metabolic control. Methods and Results: Twenty type 2 diabetes (T2D) patients (mean age 59.4 years, BMI <40 kg/m2 HbA1c >7.5%, diabetes duration ≥12 months, previously treated with NPH) were recruited to this 20-week study. Patients received once-daily detemir (0.1 U/kg) at bedtime and OAD dose remained unchanged. HbA1c was measured at baseline and end-of-trial and DTSQ completed. Mean HbA1c (8.5±1.3 vs. 7.9±1.2%, P<0.05) and waist circumference (107.0±13.4 vs. 102.2±10.5 cm, P<0.05) were significantly reduced with detemir. Treatment satisfaction significantly improved (38.9±7.0 vs. 30.3±9.5, P<0.03). No weight gain was observed after treatment with insulin detemir (from 88.9±16.7 to 85.1±15.0 kg). Conclusions: Detemir improves glycemic control for T2D patients previously on NPH, increases treatment satisfaction, and may provide additional weight-sparing benefits.