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Effects of Multiple Daily Insulin Injections on Peripheral Glucose Disposal in Latin Americans with Type 2 Diabetes Mellitus
  1. Larissa Avilés-Santa,
  2. Karin Salinas,
  3. Beverley Adams-Huet,
  4. Philip Raskin
  1. From the Department of Medicine (L.A.-S., K.S., P.R.), and the Department of Clinical Science (B.A-H), The University of Texas Southwestern Medical Center at Dallas, Dallas, TX.
  1. This project was sponsored in part by the National Institutes of Diabetes, Digestive and Kidney Diseases, K08 award DK02606, and by and the National Institutes for General Clinical Research Centers M01-RR00633.
  2. Address correspondence to: Dr. Larissa Avilés-Santa, The University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd G5.238, Dallas, TX 75390-8858; e-mail: Maines.Aviles-Santa{at}UTSouthwestern.edu.

Abstract

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

Methods and 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/m2and 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.

Key words
  • insulin sensitivity
  • obesity
  • percent body fat
  • intensive insulin therapy
  • premenopausal women
  • type 2 diabetes
  • Latinos

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