INSULIN THERAPY AND WEIGHT CHANGE IN NATIVE-AMERICAN NIDDM PATIENTS

OBJECTIVE - To determine whether NIDDM patients exposed to insulin therapy in a clinical setting gain weight. RESEARCH DESIGN AND METHODS - This study, an historical cohort chart review, was conducted at the IHS clinic on the Navajo Reservation in Northern Arizona. We studied 27 Native Americans with NIDDM and 102 Native-American nondiabetic control subjects. RESULTS - Insulin therapy consisting of a mean of 105 U/day was associated with a mean weight gain of 3.0 +/- 2.2 kg/yr. When insulin was discontinued or decreased, a mean weight loss of 5.2 +/- 2.7 kg/yr was observed in the same patients. No significant weight gain was noted in 102 nondiabetic control subjects, nor in 20 of 27 insulin-treated patients given oral hypoglycemic agents before initial insulin therapy. CONCLUSIONS - Insulin therapy appeared to be associated with weight gain m this group of NIDDM patients. This suggests that observations for weight gain be undertaken when treating NIDDM patients with insulin, because it may exacerbate the underlying pathophysiology of the disease.