Kamran Rashid, Khalilur Rehman, Saeed Anwer, Aaeisha Qureshi, Basharat R A.
Insulin requirement in diabetic patients with chronic renal failure due to Diabetic Nephropathy (DN).
Biomedica Jan ;20(2):79-84.

This study was performed in the Department of Medicine, Postgraduate Medical Institute and Lahore General Hospital, Lahore. One hundred patients of type 1 and type 2 diabetes with diabetic nephropathy induced chronic renal failure, of either sex; the ages above 18 years were included in the study. Patients, recruited, were investigated to rule out any other cause of renal failure. Data was collected on a questionnaire regarding duration of diabetes, previous diabetic treatment and compliance. Patients were put on insulin and their daily blood glucose charts were maintained. When the patients achieved optimal glycaemic control, total amount of insulin per day was recorded. This study included a total of l00 diabetics, 12 (7 men, 5 women) had type 1 and 88 (41 men, 47 women) had type 2 disease. Duration of diabetes was higher in type 1 (15.6±3.2 years) than in type 2 diabetes (9.7±5.0 years). All patients with type 1 diabetes required insulin but there was reduction of 28.2%-60.0% as compared to maximum units taken prior to renal impairment. About 35.2% patients of type 2 diabetes did not require any insulin. Mean insulin requirement was lower in type 2 diabetics (14.8±14.6 units/day) than in type 1 diabetics (34.3±9.9 units/day). The Pearson correlation (2-tailed) between serum creatinine and 24 hour insulin requirement was significant (P=0.01). The purpose of this study was to find out the requirement of insulin for optimal glycaemic control in diabetics with impaired renal function due to diabetic nephropathy. It was concluded that the patients with impaired renal function due to DN had lower requirement of insulin than before the development of DN. Type 1 diabetic patients had significant reduction in insulin compared to the requirement prior to DN. Some type 2 diabetic patients did not require any treatment.

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