Why and how do insulin agents act on weight

Czech version

Authors: Štěpán Svačina
Authors‘ workplace: III. interní klinika 1. LF UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA
Published in: Vnitř Lék 2014; 60(5-6): 448-453
Category: Review

Overview

The weight gain in insulin therapy is known phenomenon for decades. Different types of insulin and insulin analogues differ in many clinical effects, e.g. duration of action, risk of hypoglycaemia and effect on the weight as well. These effects vary with change of insulin for insulin analogues and vice versa. It has been unclear for a long time why some insulin analogues have positive effect on weight gain. Currently, it is obvious that several factors are crucial: binding to albumin, reduction of hypoglycaemia events, dissociation between hepatic and peripheral effects, influence on renal function and differences in action of insulin in brain. Therefore, we know how to use beneficial effect of particular agent in daily practice. In addition, we know pathogenetic mechanisms that influence the weight – in other words, we can answer the question why and how does particular agent change the weight.

Key words:
binding to albumin – fluid retention – hypoglycaemia – insulin – insulin analogues – insulin in brain – weight

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