INSULIN DEFICIENCY AMONG NEWLY DIAGNOSED TYPE 2 DIABETICS
AbstractBackground: Any patient above the age of 40 years, coming with the symptoms of diabetes islabelled as type 2 diabetic. If insulin levels are included in the protocol for initial investigations ofdiabetic patients, they can be differentiated as having insulin deficiency or insulin resistance. Theycan thus be treated accordingly. This study was conducted to see the prevalence of insulinresistance and insulin deficiency in newly diagnosed type 2 diabetics. Methods: This study wasconducted on 75 newly diagnosed diabetic subjects, and 75 control subjects for comparison.Fasting serum insulin was assayed by ELISA and HOMA-IR index was calculated. The diabeticsubjects with fasting hyperglycaemia and serum insulin level below 20 µIU/ml and HOMA-IRindex below 3.5 were grouped as insulin deficient (Group-A), and the diabetic subjects withfasting insulin level above 20 µIU/ml and HOMA-IR index above 3.5 were grouped as insulinresistant (Group-B). Results: Twenty-eight percent subjects were found to have insulin levelbelow 20 µIU/ml while 72% subjects had insulin resistance. When gender was taken intoconsideration, it was seen that 18.7% males had fasting insulin level of 6.98±0.737 µIU/ml and9.3% females had fasting insulin level of 5.21±0.885 µIU/ml while 32% males and 40% femaleshad insulin resistance. The mean age of male subjects with insulin resistance was significantlyhigher compared to the male subjects with insulin deficiency. Mean weight and body mass indexof the male and female subjects having insulin resistance was significantly higher than theirrespective control groups and also higher than the subjects with insulin deficiency. Pearsoncoefficient of correlation was calculated for fasting serum insulin level with age and BMI. Asignificant positive correlation was observed between fasting serum insulin and age of femaleswith insulin resistance. Conclusion: A considerable number of persons who develop diabetes after40 years of age but are not insulin resistant. Twenty-eight percent subjects have relative insulindeficiency, and 72% subjects have insulin resistance.Keywords: Type 2 diabetics, insulin deficiency, BMI
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