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Volume 23 |
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Volume 23 |
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Number 2 |
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Insulin therapy induced adiposity evaluated
by computed tomography is not visceral
Ahmed Elsayed1, Soliman ElGebely2, Ahmed Galal3
ABSTRACT
Objective: In individuals with type 2 diabetes, weight gain during treatment with insulin and other agents prevents the attainment of glycemic targets and probably limits the success of treatment. Studies have attempted to elucidate the mechanisms behind the apparent paradox of insulin improving glycemic control and cardiovascular risks, while causing weight gain. The aim of this study is to clarify the influence of insulin therapy on body weight and differential fat distribution (visceral or peripheral) in newly insulin treated type 2 diabetic male patients.
Patients and Methods: The study was conducted on 26 type 2 diabetic male patients evaluated at baseline and 12 months after instituting insulin therapy. Body mass index (BMI), absolute waist circumference (AWC), systolic and diastolic blood pressure, HbA1c% were estimated. Abdominal Computed tomography was applied to evaluate areas of subcutaneous fat (SF) and visceral fat (VF) before and after insulin therapy.
Results: There is significant reduction in HbA1c (9.03±0.72 vs. 7.50±0.58, p<0.001) and significant increase body mass index (BMI =28.92±1.39 vs. 29.81±1.27, p=0.02) .However there was non significant changes in the AWC 103.27±3.87 Vs 105.14±3.25, P=0.065, VF 121.01±5.84 Vs 123.01±5.55, p=0.213, SF 206.54±9.93 Vs 212.12±11.62, P = 0.069and V/S ratio 0.59±0.03 vs. 0.58±0.03, P=0.365.
Conclusion: Weight gain in the newly insulin treated type 2 diabetic patients during 12 months duration is equally distributed in both peripheral and visceral fat. So, insulin therapy does not appear to increase the visceral fat in type 2 diabetic patients which is strongly liked to atherosclerosis. Longer-term follow up and bigger sample size are necessary to address the issue of the kinetics of weight gain and to establish the possible correlation with other cardiovascular risk markers.
KEYWORDS: Insulin therapy, Type 2 diabetes, Adiposity, Visceral fat, Fat distribution, Computed tomography.Pak J Med Sci April 2007 Vol. 23 No. 2 161-166
1. Dr. Ahmed Elsayed, MD
Specialist Endocrinologist
Endocrinology Unit,
Al-Amiri Hospital,
Kuwait.
2. Dr. Soliman ElGebely, MD
Specialist Diabetologist,
Diabetes Unit, Mubarak Al-Kabeer Hospital,
Kuwait.
3. Dr. Ahmed Galal, MD
Prof. of Radiology,
Mansoura University,
Egypt
Correspondence
Dr Ahmed Elsayed,
E-mail: ahmedemam6@hotmail.com
* Received for Publication: June 27, 2006
* Revision Received: July 17, 2006
* Revision Accepted: January 3, 2007
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