Differential metabolic effects of insulin detemir versus NPH in patients with type 2 diabetes

We investigate whether lower weight gain with insulin detemir is due to a decrease in energy intake or an increase in energy output and whether any change in energy balance is accompanied by changes in hormones, lipid metabolism and muscle gene expression. Twenty subjects with type 2 diabetes were titrated for 8 weeks with NPH insulin, then randomized to detemir or NPH for 16 weeks. Body composition, energy expenditure (EE), energy intake, fasting and prandial metabolites and hormones were measured at 8 and 24 weeks. In a subset of subjects (n=10), gene expression profiling was performed in skeletal muscle biopsies taken at 8 weeks (pre-treatment) and 24 weeks (post-treatment).