{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T13:32:43Z","timestamp":1777555963663,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2021,11,25]],"date-time":"2021-11-25T00:00:00Z","timestamp":1637798400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Is insulin initiation linked to increasing body mass index (BMI) in all patients with type-2-diabetes (T2D)? To determine distinct longitudinal patterns of BMI change over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      5057 patients with T2D (55% males, median BMI [IQR]: 30.0 [26.9\u201333.3] kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) aged \u226540 years at diabetes diagnosis and with \u22652 years of follow-up after insulin initiation irrespective of previous or concurrent use of metformin\/dipeptidyl peptidase-4-inhibitor from the multicenter prospective diabetes registry DPV were studied. To identify subgroups following a similar pattern of BMI change after insulin initiation, longitudinal group-based trajectory modeling was applied. Multinomial logistic regression was then used to analyze covariates associated with group membership.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Three heterogeneous groups with either relevant\n                      <jats:italic toggle=\"yes\">BMI increase<\/jats:italic>\n                      (delta-BMI: +4.0\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      after 2 years; 12% of patients);\n                      <jats:italic toggle=\"yes\">slight BMI increase<\/jats:italic>\n                      (+0.4\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; 80%); or\n                      <jats:italic toggle=\"yes\">BMI decrease<\/jats:italic>\n                      (\u22123.2\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; 8%) were identified. Patients with older age [OR (95% CI): 1.37 (1.11\u20131.69)] and obesity [2.05 (1.65\u20132.55)] before insulin start were more often in the\n                      <jats:italic toggle=\"yes\">BMI decreasing<\/jats:italic>\n                      group, and less often in the\n                      <jats:italic toggle=\"yes\">BMI increasing<\/jats:italic>\n                      class [0.80 (0.67\u20130.95); 0.82 (0.69\u20130.98)]. A worse HbA1c both at insulin start and during follow-up [1.90 (1.60\u20132.26); 1.17 (1.07\u20131.27)], a higher insulin dose [1.67 (1.33\u20132.10)], and severe hypoglycemic events [2.38 (1.60\u20133.53)] after insulin initiation were all linked with higher odds of belonging to the\n                      <jats:italic toggle=\"yes\">BMI increasing<\/jats:italic>\n                      trajectory.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Patient heterogeneity with respect to weight gain after initiation of insulin therapy in adult T2D was detected by an objective computer algorithm. Older people with obesity should not defer from insulin use due to fear of weight gain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/dia.2021.0144","type":"journal-article","created":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T10:37:43Z","timestamp":1631702263000},"page":"799-806","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Not All Type-2-Diabetes Patients Increase Body Mass Index After Initiating Insulin: Results of Latent Class Analysis from the DPV Registry"],"prefix":"10.1177","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7570-9095","authenticated-orcid":false,"given":"Nicole","family":"Prinz","sequence":"first","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany."},{"name":"German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anke","family":"Schwandt","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany."},{"name":"German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernadette","family":"Borgert","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Diabetology and Angiology, DRK Hospital, Berlin, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bettina","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Diabetology, Heilig-Geist Hospital, Bensheim, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans-Peter","family":"Kempe","sequence":"additional","affiliation":[{"name":"Diabetologikum DDG, Ludwigshafen, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7854-4233","authenticated-orcid":false,"given":"Julia K.","family":"Mader","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigrund","family":"Merger","sequence":"additional","affiliation":[{"name":"Clinic for Endocrinology, Diabetology, Metabolism, and Nutrition Medicine, Regiomed Clinic Coburg, Coburg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosmarie","family":"Weber-Lauffer","sequence":"additional","affiliation":[{"name":"Specialized Diabetes Practice, Karlsruhe, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank-J\u00fcrgen","family":"Wosch","sequence":"additional","affiliation":[{"name":"Specialized Diabetes Practice, Hanau, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1395-4842","authenticated-orcid":false,"given":"Reinhard W.","family":"Holl","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany."},{"name":"German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on Behalf of the DPV Initiative","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,11,25]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-016-0120-z"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-018-4729-5"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","unstructured":"Bundes\u00e4rztekammer (B\u00c4K) Kassen\u00e4rztliche Bundesvereinigung (KBV) Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF): [Nationale Versorgungsleitlinie typ-2-diabetes\u2014Langfassung 2. 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