Effects of multiple daily insulin injections on peripheral glucose disposal in Latin Americans with type 2 diabetes mellitus.
OBJECTIVE
To evaluate the effects of insulin in multiple daily injections (MDI) on peripheral glucose disposal in Latin American patients with type 2 diabetes.


RESULTS
Ten Latin American patients (four men and six women) with type 2 diabetes between the ages of 32 and 45 years were evaluated. All women were premenopausal and had regular menstrual periods. A hyperinsulinemic-euglycemic clamp procedure was performed at baseline and was repeated approximately 2 years after insulin monotherapy on MDI was initiated. Both genders had comparable baseline anthropometric and laboratory features, including a mean body mass index > 30 kg/m2 and percent body fat > 30%. Baseline percent hemoglobin A1c (HbA1c%) was 9.5 +/- 1.5%, and post-intervention HbA1c% was 7.0 +/- 1.2%. The peripheral glucose disposal rate at baseline was 4.5 +/- 2.2 mg/kg/min fat-free mass and at postintervention was 3.6 +/- 2.3 mg/kg/min fat-free mass.


CONCLUSIONS
Despite a significant improvement in glycemic control, MDI did not seem to increase the insulin-mediated glucose disposal rate. Underlying obesity and increased percent body fat may have been the most counteracting factors on the potential improvement in insulin sensitivity expected with insulin monotherapy.
Avilés-Santa
Larissa
L
Department of Medicine, The University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd G5.238, Dallas, TX 75390-8858, USA. Maines.Aviles-Santa@UTSouthwestern.edu
Salinas
Karin
K
Adams-Huet
Beverley
B
Raskin
Philip
P
D050154:Adiposity / Q000187:drug effects / Q000208:ethnology; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D015309:Glucose Clamp Technique; D006442:Glycated Hemoglobin; D006454:Hemoglobins / Q000032:analysis / Q000187:drug effects; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007267:Injections; D007328:Insulin / Q000008:administration & dosage*; D007333:Insulin Resistance / Q000208:ethnology; D007843:Latin America / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000208:ethnology; D013781:Texas / Q000453:epidemiology
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D006454:Hemoglobins; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human