INS and type 2 diabetes mellitus: The most important risk factors for early worsening were a higher HbA1c level at screening, a large reduction of HbA1c (> 2%), and the severity of DRD at baseline.53, 54, 55 A similar phenomenon was reported in patients with T2D after a rapid improvement of blood glucose levels when they were changed from oral agents or diet alone to insulin therapy,56,57 and more recently after bariatric surgery.58