27th May 2025

A 38-year-old female patient is reviewed at her annual endocrinology clinic for diabetes.

A 38-year-old female patient is reviewed at her annual endocrinology clinic for diabetes. Her HbA1c is 50mmol/mol. She reports that she has not missed any doses of her insulin, has been gaining weight and has not had any hypoglycaemic episodes in the past year. She has some lumps on her lower abdomen that are firm but not painful. What is the most reason for the uncontrolled blood sugar in this patient?