Clinical parameters (body mass index and age) are the best predictors for the need of insulin therapy during the first 18 months of diabetes mellitusin young adult patients

To address the question whether there are simple clinical predictors of nee d for insulin in the first 18 months of treatment of diabetes presenting in young adult subjects, a prospective study of 24 patients with diabetes mel litus (age: 18-40 years) was designed. At diagnosis of diabetes, age, sex, body mass index (BMI:I, glycemia, ketonuria, C-peptide, insulin autoantibod ies, islet cell antibodies and glutamic acid decarboxylase antibodies were recorded before starting any treatment. At the end of the follow-up (18+/-4 months), they were divided into two groups according to their need for ins ulin therapy: group 1 (n=15; 62%), who needed insulin therapy, and group 2 (n=9; 38%), who did not. Each marker was related to actual need for therapy necessity. Multivariate analysis showed that BMI and age were the variable s with greatest predictive value regarding need for insulin. These data rev eal that the need for insulin therapy in young adult diabetic patients may be supported by the clinical criteria of age and BMI, which are both easily and quickly determined.