RESUMO
OBJECTIVES: Type 1 diabetes mellitus (T1DM) is characterized by a selective destruction of pancreatic beta cells. Recent data suggest a role of insulin resistance (IR) along with the deficient insulin reserve. METHODS: Fifty-eight consecutive patients of T1DM, with low C-peptide levels were included. Patients with an obvious secondary cause like steroid therapy, fibrocalculous pancreatic disease, chronic infections or comorbid illness were excluded. A clinical assessment for the presence of obesity was made based on anthropometric data. Clinical markers of IR and the insulin dose required to achieve a stable glycemic control calculated in terms of body weight were also studied. RESULTS: There were 30 males and 28 females with a mean age of 16.5 +/- 2.3 (5-39) years. The mean body mass index (BMI) was 19.21 +/- 3.7 and the waist circumference was 67 +/- 5.2 cms. Nineteen ( 32.75%) and six (10.34%) patients were overweight (BMI > 23) and obese (BMI > 27) respectively while 16 (27.58%) had abdominal obesity. The body fat percentage was high (> 25%) in 34 (58.62%), mean 28.33 +/- 11.4%. Acanthosis nigricans was found in 14 (24.13%) cases, hypertension in two (3.4%) but none of the girls had clinical polycystic ovarian syndrome (PCOS). The insulin dose required was 1.11 +/- 0.41 u/kg (0.3-2.9) at an glycated haemoglobin A1C (A1C) of 7.56 +/- 1.04% (4.9-9.3), it was more than 0.6 u/kg/day in 38 (65.51%) patients. CONCLUSIONS: The study concludes that IR is present in a large number of Indian T1DM patients along with a high body fat percentage.