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- Title
Predictors of insulin sensitivity in Type 2 diabetes mellitus.
- Authors
Bonora, E.; Targher, G.; Alberiche, M.; Formentini, G.; Calcaterra, F.; Lombardi, S.; Marini, F.; Poli, M.; Zenari, L.; Raffaelli, A.; Perbellini, S.; Zenere, M. B.; Saggiani, F.; Bonadonna, R. C.; Muggeo, M.
- Abstract
Abstract Aims To identify the independent predictors of insulin sensitivity in Type 2 diabetes, and to establish whether isolated Type 2 diabetes (i.e. diabetes without overweight, dyslipidaemia and hypertension) is a condition of insulin resistance. Methods We examined 45 patients with non-insulin-treated Type 2 diabetes undergoing a 4-h euglycaemic hyperinsulinaemic clamp (20 mU/m2 per min) combined with 3 H-3-D-glucose and 14 C-U-glucose infusions and indirect calorimetry. We also examined 1366 patients with non-insulin-treated Type 2 diabetes randomly selected among those attending the Diabetes Clinic and in whom insulin resistance was estimated by Homeostasis Model Assessment (HOMA-IR). Results In the 45 patients undergoing glucose clamp studies, insulin-mediated total glucose disposal (TGD) was independently and negatively associated with systolic blood pressure (standardized β coefficient = -0.407, P = 0.003), plasma triglycerides (β= -0.355, P = 0.007), and HbA1c (β= -0.350, P = 0.008). The overall variability of TGD explained by these variables was 53%. Overweight diabetic subjects with central fat distribution, hypertension, hypertriglyceridaemia and poor glycometabolic control had insulin-mediated TGD values markedly lower than their lean counterparts without hypertension, with normal triglycerides, and with good glycometabolic control (16 ± 5 vs. 31 ± 10 µmol/min per kg lean body mass, P < 0.01). Nevertheless, the latter still were markedly insulin-resistant when compared with sex- and age-matched non-diabetic control subjects (31 ± 10 vs. 54 ± 13 µmol/min per kg lean body mass, P < 0.01). In the 1366 Type 2 diabetic patients of the epidemiological study, HOMA-IR value was independently associated with HbA1c (β = 0.283, P < 0.0001), plasma triglycerides (β = 0.246, P < 0.0001), body mass index (β = 0.139, P < 0.001), waist girth (β...
- Subjects
INSULIN resistance; TYPE 2 diabetes; INSULIN shock
- Publication
Diabetic Medicine, 2002, Vol 19, Issue 7, p535
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1046/j.1464-5491.2002.00764.x