MILD CASE OF INSULIN RESISTANCE IN A PATIENT WITH TYPE 2 DIABETES MELLITUS (CASE REPORT)

Diabetes mellitus type 2 is a chronic metabolic disorder characterized by hyperglycemia, insulin resistance, and relative insulin deficiency. There are rare cases when even higher doses of insulin are insufficient to control the values of glycemia. The insulin resistance can be mild, moderate or severe. Authors present a clinical case report of a mild insulin resistance in a 46 year-old female patient with clinical symptoms of insulin resistance (including obesity), treated for seven years with oral antidiabetic drugs. Because of poor glycemic control and diabetes complications, insulin treatment was suggested. Glycemic control was not acheived with different types of insulin at the initial stage of the insulin therapy. The patient was hospitalized and after regimen adjustment with various insulin combinations, glycemic control was achieved with 2 insulin units per kilogram (130 IU per day in total), while the patient weighed 60 kilograms. In the presented case, which can be considered a mild insulin resistance, the satisfactory glycemic control was established with use of moderately high doses of insulin. Oftentimes people with mild insulin resistance get overlooked by the doctors and lost in the system. The discussions should be focused on the issues of when it is important for specialists to recognize insulin resistance and what to consider as a primary treatment in obese patients with insulin resistance symptoms and signs.