5 May 2016

Carmel Sparke

Type 2 diabetes patients who start on insulin will gain on average 3kg in the first year, but oral medications may help limit this, Victorian research shows.

A study of 340 patients who attended a Melbourne diabetes outpatient clinic between 1998 and 2015 showed that most put on weight after starting insulin.

But by using newer oral medications in combination with insulin and avoiding short-acting insulin patients may be able to prevent weight gain, the study found.

In the study, 39% of patients gained more than 5% of their body weight, and of these, 12% gained more than 10% of their baseline weight.

Weight gain was associated with higher insulin doses, the use of short-acting insulin and with lower body weight at the start of the study.

“Treatment regimens that avoid short-acting insulin but include oral agents other than thiazolidinediones might prevent insulin-induced weight gain in type 2 diabetes patients,” the researchers said.

They pointed out that data were collected at a time when very few insulin-sparing therapies, such as GLP-1 analogues and SGLT2 inhibitors, were available, and thus it should not be assumed that similar degrees of weight gain would be seen in patients today.

Dr Gary Deed, chair of the RACGP’s diabetes specific interest group, said the weight gain effect of starting insulin was well known, but it need not be inevitable, particularly if the GP and patient focused on lifestyle factors including increasing activity and attention to diet.

He said he usually recommended that a patient starting insulin saw an accredited dietitian and perhaps an exercise physiologist for advice on increasing activity.

Last Reviewed: 05/05/2016

Australian Doctor


Factors associated with insulin-induced weight gain in an Australian type 2 diabetes outpatient clinic. Internal Medicine 2016; online.