Insulin detemir improves glycaemic control without weight gain in insulin-naive patients with type 2 diabetes : subgroup analysis from the PREDICTIVE™ study

()3.7 mmol ⁄ l; p < 0.0001), and within-patient fasting glucose variability ()0.5 mmol ⁄ l; p < 0.0001). In the majority of patients (82%), these improvements in glycaemic control were achieved with once daily administration of insulin detemir. There was a small reduction in mean body weight ()0.7 kg; p < 0.0001), which was most apparent in patients with a higher body mass index (BMI) at baseline. A significant negative relationship between weight change and baseline BMI was observed (greater the BMI, greater the weight reduction). Multiple regression analysis showed that BMI and HbA1c at baseline, and change in HbA1c, were all predictors for weight change (p < 0.0001 for all), with BMI being the strongest predictor. Conclusions: Patients with type 2 diabetes nao¨ve to insulin can be effectively treated with once-daily insulin detemir (± OADs) to achieve improved glycaemic control with no adverse effect on weight and a low risk of hypoglycaemia. These short-term results are consistent with the findings of clinical trials. What’s known It has been well documented that insulin therapy can result in significant weight gain. Furthermore, this insulin-associated weight gain can act as a barrier to effective treatment of diabetes. This is due to a number of factors such as increased insulin resistance, cardiovascular risks, poor compliance and reluctance to start insulin treatment (in patients with type 2 diabetes).