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Obesity Causes Delay in Hypoglycemic Effects of Insulin

Higher doses of insulin may lower absorption efficiency in obese patients with type 2 diabetes

TUESDAY, Dec. 28 (HealthDay News) -- Hypoglycemic action and absorption of increasing dosages of short-acting insulin are delayed in obese patients with type 2 diabetes, according to a report in the December issue of Diabetes Care.

Maude Gagnon-Auger, of the Université de Sherbrooke in Canada, and colleagues evaluated the kinetics of short-acting insulin in obese patients (body mass index, >30 kg/m²) with type 2 diabetes. The researchers compared six lean subjects receiving 10 units of insulin in one eight-hour experiment to seven obese patients with type 2 diabetes in three eight-hour experiments, with increasing insulin dosages of 10, 30, and 50 units.

The ATBF in obese patients was 64 percent lower than the ATBF in the control-group patients. The investigators found that subcutaneous fat thickness, obesity, and low ATBF reduced insulin absorption, but not when low doses of insulin were administered. This suggested that high insulin needs in obese patients may account for low absorption efficiency with higher doses. The researchers also found that, in the obese patients, the absorption and activity of the insulin and the hypoglycemic action were severely delayed as the insulin dosage increased.

"This study shows that absorption and hypoglycemic action of short-acting insulin analogs are critically delayed at incrementally larger dosages in obese subjects with type 2 diabetes," the authors write.

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