Mee Kyoung Kim1, Eun Hee Jang1, Jang Won Son1, Hyuk-Sang Kwon1, Ki-Hyun Baek1, Kwang-Woo Lee1, Ki-Ho Song2. 1. Department of Internal Medicine, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, 62 Yeouido-dong Youngdeungpo-gu, Seoul 150-713, Republic of Korea. 2. Department of Internal Medicine, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, 62 Yeouido-dong Youngdeungpo-gu, Seoul 150-713, Republic of Korea. Electronic address: kihos@catholic.ac.kr.
Abstract
AIMS: Basal insulin requirement in patients with type 2 diabetes is difficult to determine because of individual variability in insulin sensitivity and secretion. We aimed to identify factors that influence basal insulin requirement in insulin-naïve patients with type 2 diabetes. METHODS: We studied 50 insulin-naïve patients with type 2 diabetes. Their basal insulin requirement was calculated by 8h overnight intravenous insulin infusion. Patients underwent abdominal computed tomography; subcutaneous and visceral fat areas were measured. RESULTS: The basal insulin requirement was 31.3 ± 16.9 units/day, and it varied widely from 0.2 to 1.4 units/kg. It was positively correlated with visceral fat area (γ=0.485, P<0.001), body mass index (BMI, γ=0.339, P=0.008), glycated hemoglobin (HbA1C, γ=0.327, P=0.019), alanine aminotransferase (ALT, γ=0.310, P=0.027), and triglyceride (γ=0.305, P=0.032). However, body weight, waist circumference and total fat mass were not related to basal insulin requirement. Multiple linear regression analysis showed that visceral fat area, HbA1C, and ALT are independent predictors of basal insulin requirement. CONCLUSIONS: Visceral obesity was a better predictor than generalized obesity for basal insulin requirement at the initiation of insulin therapy in patients with type 2 diabetes.
AIMS: Basal insulin requirement in patients with type 2 diabetes is difficult to determine because of individual variability in insulin sensitivity and secretion. We aimed to identify factors that influence basal insulin requirement in insulin-naïve patients with type 2 diabetes. METHODS: We studied 50 insulin-naïve patients with type 2 diabetes. Their basal insulin requirement was calculated by 8h overnight intravenous insulin infusion. Patients underwent abdominal computed tomography; subcutaneous and visceral fat areas were measured. RESULTS: The basal insulin requirement was 31.3 ± 16.9 units/day, and it varied widely from 0.2 to 1.4 units/kg. It was positively correlated with visceral fat area (γ=0.485, P<0.001), body mass index (BMI, γ=0.339, P=0.008), glycated hemoglobin (HbA1C, γ=0.327, P=0.019), alanine aminotransferase (ALT, γ=0.310, P=0.027), and triglyceride (γ=0.305, P=0.032). However, body weight, waist circumference and total fat mass were not related to basal insulin requirement. Multiple linear regression analysis showed that visceral fat area, HbA1C, and ALT are independent predictors of basal insulin requirement. CONCLUSIONS:Visceral obesity was a better predictor than generalized obesity for basal insulin requirement at the initiation of insulin therapy in patients with type 2 diabetes.
Authors: Anand Thakarakkattil Narayanan Nair; Louise A Donnelly; Adem Y Dawed; Sushrima Gan; Ranjit M Anjana; Mohan Viswanathan; Colin N A Palmer; Ewan R Pearson Journal: Endocrinol Diabetes Metab Date: 2020-01-07
Authors: Manju Mamtani; Hemant Kulkarni; Thomas D Dyer; Laura Almasy; Michael C Mahaney; Ravindranath Duggirala; Anthony G Comuzzie; John Blangero; Joanne E Curran Journal: PLoS One Date: 2013-03-11 Impact factor: 3.240