title: Visceral obesity is a better predictor than generalized obesity for basal insulin requirement at the initiation of insulin therapy in patients with type 2 diabetes.
abstract: OBJECTIVE
  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.affiliation: 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.
authors.forename: Mee Kyoung
authors.initials: MK
authors.lastname: Kim
authors.affiliation: 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.
authors.forename: Eun Hee
authors.initials: EH
authors.lastname: Jang
authors.affiliation: 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.
authors.forename: Jang Won
authors.initials: JW
authors.lastname: Son
authors.affiliation: 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.
authors.forename: Hyuk-Sang
authors.initials: HS
authors.lastname: Kwon
authors.affiliation: 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.
authors.forename: Ki-Hyun
authors.initials: KH
authors.lastname: Baek
authors.affiliation: 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.
authors.forename: Kwang-Woo
authors.initials: KW
authors.lastname: Lee
authors.affiliation: 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.
authors.forename: Ki-Ho
authors.initials: KH
authors.lastname: Song
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D054796:Drug Dosage Calculations; D006442:Glycated Hemoglobin; D006801:Humans; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D050152:Intra-Abdominal Fat; D008875:Middle Aged; D009765:Obesity; D056128:Obesity, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D000410:Alanine Transaminase; D006442:Glycated Hemoglobin; D007328:Insulin