Weight Gain Clinical Trial
Official title:
Effects of Insulin Detemir and NPH Insulin on Renal Handling of Sodium, Fluid Retention and Weight in Type 2 Diabetic Patients
Hypothesis: Changing type 2 patients treatment from Insulin Insulatard to Insulin Detemir will increase their excretion of sodium in the urine and thereby decrease their extracellular volume and body weight. 24 patients are divided into 2 groups and their insulin treatment is shifted while their body composition, sodium excretion, weight and extracellular volume is monitored.
Type 2 diabetic patients experience weight gain when receiving insulin treatment. There has
been reports that the weight gain is less or absent when patients are treated with Insulin
Detemir. Patients with diabetes have increased total body sodium and increased extracellular
volume. We hypothesize that part of the weight gain seen is due to increase in extracellular
volume and that the lesser weight gain seen in patients treated with Detemir is due to an
lesser increase in extracellular volume. We believe that the cause of this difference is the
different pharmacokinetic properties of insulin Detemir. Insulin Detemir i protein bound and
is therefore not excreted in the kidneys. This may cause less sodium reabsorption, than with
other insulins, and therefore less increase in extracellular volume.
We test this hypothesis by examining urinary sodium excretion, extracellular volume by GFR
measurements, Body composition by DEXA scan, body weight, and 24 hour blood pressure.In
patients that are changed from Insulin Insulatard to Insulin Detemir and back.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Basic Science
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