Managing Highly Insulin-Resistant Diabetes Mellitus: Weight Loss Approaches and Medical Management

The prevalence of obesity and diabetes is epidemic. Severe insulin resistance (defined I as the need for >= 200 units of insulin per clay to achieve glycemic control) is commonly see 1 with obesity and can complicate diabetes management. The management of patients with diabetes who have severe insulin resistance is difficult. and at times frustrating and requires a multifaceted approach. Weight loss is the best treatment option, which can be a challenging task for patients to achieve and maintain. Medications that decrease insulin needs like metformin., thiazolidinediones, or pramlintide may, help, but some patients also need high Closes of insulin. This article reviews these different treatment options and provides practical advice on weight loss, use Of insulin sensitizers, and use of U-500 insulin.