title: Clinical profile of patients using normal, high and very high insulin doses in type 2 diabetes.
abstract: OBJECTIVE
  Insulin requirement varies between patients with diabetes due to insulin resistance. The clinical profile of patients based on their insulin requirement has not been studied earlier. We stratified the patients based on total daily insulin requirement (TDIR) and studied their clinical profile and carbohydrate consumption.
  
  
  METHODS
  Sixty patients with type 2 diabetes (aged 30-75 years, using stable insulin dose for last 6 months, HbA1c between 6-7.5%, negative screening tests for Acromegaly and Cushing's disease) participated in this clinical observational study. All patients with major illness, surgery or diabetic ketoacidosis were excluded. The patients were divided into 3 groups: Group 1 (TDIR<1 U/kg, n=30), Group 2 (TDIR 1-2 U/kg, n=20) and Group 3 (TDIR>2U/kg, n=10). Data are presented as mean±S.D and comparison between three groups was done using one way ANOVA test.
  
  
  RESULTS
  The patients (27M: 33F) had mean age 54.3 ± 12.3 years, diabetes duration 10.1±4.7 years and an A1c of 7±0.38%. Patients in group 3 had lower body weight, BMI and highest carbohydrate consumption when compared with the other two groups (P<0.05). Hypoglycemic episodes and complications did not differ between the groups.
  
  
  CONCLUSIONS
  Our data showed that the low body weight and high carbohydrate intake are associated with increased insulin requirement. The clinical implications of our study are to check the carbohydrate intake in patients with high insulin requirement.
authors.affiliation: Department of Endocrinology, Command Hospital, Lucknow 226002, U.P., India. Electronic address: hariendo@rediffmail.com.
authors.forename: K V S
authors.initials: KV
authors.lastname: Hari Kumar
authors.affiliation: Department of Endocrinology, Command Hospital, Lucknow 226002, U.P., India.
authors.forename: A K
authors.initials: AK
authors.lastname: Gupta
authors.affiliation: Department of Endocrinology, Command Hospital, Lucknow 226002, U.P., India.
authors.forename: Amit
authors.initials: A
authors.lastname: Kumar
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004040:Dietary Carbohydrates; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged
chemical_list: D004040:Dietary Carbohydrates; D007328:Insulin
keywords: High insulin requirement; Insulin dose; Insulin resistance; Type 2 diabetes