Abstract
Aims/hypothesis
Insulin therapy in patients with type 2 diabetes mellitus is accompanied by weight gain characterised by an increase in abdominal fat mass. The expansion of adipose tissue mass is generally paralleled by profound morphological and inflammatory changes. We hypothesised that the insulin-associated increase in fat mass would also result in changes in the morphology of human subcutaneous adipose tissue and in increased inflammation, especially when weight gain was excessive.
Methods
We investigated the effects of weight gain on adipocyte size, macrophage influx, and mRNA expression and protein levels of key inflammatory markers within the adipose tissue in patients with type 2 diabetes mellitus before and 6 months after starting insulin therapy.
Results
As expected, insulin therapy significantly increased body weight. At the level of the subcutaneous adipose tissue, insulin treatment led to an influx of macrophages. When comparing patients gaining no or little weight with patients gaining >4% body weight after 6 months of insulin therapy, both subgroups displayed an increase in macrophage influx. However, individuals who had gained weight had higher protein levels of monocyte chemoattractant protein-1, TNF-α and IL-1β after 6 months of insulin therapy compared with those who had not gained weight.
Conclusions/interpretation
We conclude that insulin therapy in patients with type 2 diabetes mellitus improved glycaemic control but also induced body weight gain and an influx of macrophages into the subcutaneous adipose tissue. In patients characterised by a pronounced insulin-associated weight gain, the influx of macrophages into the adipose tissue was accompanied by a more pronounced inflammatory status.
Full Article http://link.springer.com/
Graham
9 comments:
You must spend all your time looking for articles that support low carb and are anti diabetic drugs/insulin.
How about posting some articles that do not agree with your bias?
I think Graham needs to get a life, find a hobby.
Make a bucket list and do something.
Oh dear up early this morning, Xmas shopping to do today eh. Drop back in this afternoon for tea and Hobnobs. Xmas a bad time for you, brings back memories eh.
Eddie
Thought this was a good find. Do not understand the other comments?
Concluded well
Paul B
Thanks for your comment Paul. Many negative anons are unfathomable, I often suspect over medication and too much junk food.
Eddie
Thanks Graham. This article will be of interest to many and the act that a study has been done is very encouraging.
A few years ago when I was being encouraged to go onto insulin by my Practice nurse - and refused - she denied that insulin would cause weigh gain.
She now admits that it definitely would.It was once assumed that once on insulin T2s would be just the same as T1s. Its good to see that lessons are being learned.
I once read a document which was sent out to Australian medical practices advising them on initiating insulin for T2s at the local level.It said that unless the patient gained 6kg within the first few months the insulin was not working. It went on to say that patients should not be told about this side effect, but if asked, the Practice should be careful not to blatantly lie {my words} so as to make themselves so as to avoid possible litigation.
I think Anon misses the point.We hear the other side all the time. It's out there for everyone to read and its what anyone can hear from their HCP's, not from any evil intent but because it is the official line and what they are told to say.
I think it is now generally accepted that T2s should not be given insulin until it is absolutely necessary. This is a
major shift which has taken place over the past few years. I find it encouraging. Science and the medical profession should be willing and able to reassess.
They have now had a larger population to study, consequence of people living longer with diabetes. Nothing wrong with that.
Kath
"How about posting some articles that do not agree with your bias?"
Would those be the articles influenced by big pharma bias then?
Anonymous said...
"You must spend all your time looking for articles that support low carb and are anti diabetic drugs/insulin."
The article did not even mention LowCarb though I can see were your coming from! The more carbs consumed the higher the insulin usage which in turn causes the weight gain. LowCarb on the other hand would mean less insulin and less weight gain.
"How about posting some articles that do not agree with your bias?"
You mean those that are in most cases funded by Big Pharma!
Graham
Anonymous said...
"I think Graham needs to get a life, find a hobby.
Make a bucket list and do something."
But there's a hole in bucket,dear anonymous,dear anonymous!
There's a hole in my bucket,dear anonymous, a hole!
Love and hugs
Graham
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