Final answer:
Intensive insulin therapy may not be suitable for those with a high risk of missing insulin doses, such as morbidly obese individuals with multiple health issues or certain ethnic groups prone to ketoacidosis. It's also inappropriate for those with non-responsive diabetes mellitus due to excessive insulin antagonists or defective insulin receptors.
Step-by-step explanation:
Intensive insulin therapy might be inappropriate for particular individuals with type 2 diabetes, especially in cases where there are significant risks associated with tight glucose control. For a person who is diabetic and risks missing doses of insulin, there is a danger of initiating ketoacidosis, a serious condition characterized by high levels of ketones in the bloodstream that can occur if the body starts to run out of insulin. This can be especially concerning for people of certain ethnic backgrounds, such as Hispanic and African-American individuals, who are statistically more likely to go into ketoacidosis than those of other ethnicities.
Considering a specific case study, Arya is a 50-year-old individual with insulin-dependent type 2 diabetes who is morbidly obese and has other comorbidities such as high blood pressure and cardiovascular disease. In such an individual, intensive insulin therapy must be carefully managed given their susceptibility to both hypoglycemia and hyperglycemia due to their overall health status and potential for renal dysfunction.
Furthermore, patients with insulin-non-responsive diabetes mellitus might not benefit from intensive insulin therapy due to factors such as excessive insulin antagonists, defective insulin receptors, or potential antibodies to insulin. Adjusting the insulin dose is crucial in preventing hypoglycemia, as an overly high dose could potentially be more harmful than beneficial.