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

Lookup NU author(s): Dr Peter Carey, Professor Roy Taylor

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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 of 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.

Publication metadata

Author(s): Carey PE, Stewart MW, Ashworth L, Taylor R

Publication type: Article

Publication status: Published

Journal: Hormone and Metabolic Research

Year: 2003

Volume: 35

Issue: 6

Pages: 372-376

ISSN (print): 0018-5043

ISSN (electronic): 1439-4286

Publisher: Georg Thieme Verlag

URL: http://dx.doi.org/10.1055/s-2003-41360

DOI: 10.1055/s-2003-41360

PubMed id: 12920661

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