Endocrine Abstracts

Introduction

Insulin therapy can lead to obesity which can affect the comorbidities of the type 2 diabetes. Should we consider the body mass index (BMI) before prescribing it?

Methods

Our study is prospective, randomized and comparative.We recruited patients with type 2 diabetes hospitalized for a switching to insulin in the C department of diabetology and nutrition at the National Nutrition Institute in Tunis, during 6 months.We divided the patients according to their BMI and compared the corresponding averages of the initial daily insuline dose using the Welch test.

Results

We included 50 patients with type 2 diabetes, hospitalized for a switching to insulin, 54% were men, 46% were women, with an average age of 59 years (± 11), the averge duration of diabetes was eight years (± 7), the average BMI was 29 (95% CI 27–31), the average waist size was 101 cm (95% CI 97–105 ), 28% of patients were normoponderal, 34% were overweight, 22% had stage 1 obesity, 6% had stage 2 obesity, 10% had morbid obesity.We measured the average of the initial daily insuline dose for each of these groups, it was 0.52 IU/kg/d (95% CI 0.4–0.6) for normoponderal patients, 0, 46 IU/kg per day (95% CI 0.4–0.5) for overweight patients, 0.34 IU/kg per day (95% CI 0.3–0.4) for those with stage 1 obesity, 0.36 IU/kg per d (95% CI 0.2–0.5) for those with stage 2 obesity, 0.36 IU/kg/d (95% CI 0.3–0.4) for those with morbid obesity.We found a statistically significant difference between these avearges only for the normoponderal group and the group with stage 1 obesity (P = 0.041).

Conclusion

According to this study, the initial daily insuline dose of the normoponderal patient is lower than the obese one.