A comparison of the effects of varying insulin regimens in type II diabetics on weight changes and dietary compliance

A retrospective study of NIDDM patients compared changes in glycemic control and weight between nine different insulin regimens . Ninety-th ree clinic patients completed a questionnaire addressing issues of dietary compliance, appetite and hypoglycemia for comparison with recorded HgA1C and weights. Statistical comparison of the groups found no differences at the .05 level when compared by demographic data or by HgA1C at basel ine or at the end of 6 months on insulin. Two-thirds of the sample were either using bedtime NPH combined with oral hypoglycemics (HS) o r 70 /3 0 twice each day. At 6 months, the mean decrease in HgA1C was similar in both group (1.55 +/ - 7.71 vs. 1.84 +/ - 2.21, respectively). A significant difference in weight gain was found (p=.01 ) with an increase of 0.2 pounds +/ - 4.7 for HS compared to 9.6 +/ - 10.5 . Reported dietary compliance increased in 30% of the sample with initiation of insulin, but recent diet education with a dietitian made a significant difference (p= . 006) by minimizing weight gain Mean gains of 3 . 9 +1- 9.4 were compared to 9.5 +/ - 8.1 for those without this education . Use of bedtime NPH combined with oral agents produced comparable improv ement in HgAlC with smaller weight gains, but when combined with a review of diet education the mean weight remained stable .