Prevention of weight gain when starting insulin therapy in patients with type 2 diabetes.

Most people with type 2 diabetes on maximum oral glucose lowering drugs
need insulin therapy to improve glycaemic control. However, insulin
induced weight gain is undesirable since the majority of this population
already is overweight. Weight gain is associated with insulin resistance
and increased risk of cardiovascular complications. Therefore, insulin
therapy associated weight gain should be prevented. In our study we
compare the preventive effects on insulin induced weight gain of two
different therapies that are associated with weight loss in patients
with type 2 diabetes: Liraglutide and Cognitive Behavioral Therapy.

In the first 6 months Liraglutide affects weight more than CBT, but CBT provides weight maintenance after 12 months.

Baseline, 3 months, 6 months and 12 months.

The interventions are 26 weeks liraglutide or 26 weeks cognitive behavioral therapy added to insulin therapy and usual care.



Liraglutide is a long-acting glucagon-like peptide-1 (GLP-1) analog that provides glycemic control and avoids hypoglycemia without the additional weight gain that characterizes many other glucose lowering drugs. The dose of liraglutide is 0.6 mg daily in the first week, 1.2 mg daily in the second week and 1,8 mg daily from the third week by subcutaneous injection.



The cognitive behavioral treatment consists of 8 individual meetings (45 minutes each) and 4 group meetings (90 minutes each) with a psychologist. In these meetings dysfunctional cognitions that lead to unhealthy behavior are gradually uncovered, challenged and changed into more functional cognitions that are more likely to lead to healthy behavior.