Association of estimated glucose disposal rate and chronic diabetic complications in patients with type 1 diabetes

Abstract

Introduction The role of insulin resistance in diabetic chronic complications among individuals with type 1 diabetes (T1D) has not been clearly defined. The aim of this study was to examine the performance of insulin resistance, evaluated using the estimated glucose disposal rate (eGDR) for the identification of metabolic syndrome (MS) and diabetic chronic complications. Methods Cross‐sectional study in a tertiary care centre. We included patients of 18 years and older, with at least 6 months of T1D duration. Anthropometric, clinical and biochemical data were collected. Results Seventy patients, 41 (58.6%) women, with a median age of 36.6 years (range 18–65). Mean age of onset and duration of diabetes was 13.5 ± 6.5 and 23.6 ± 12.2 years, respectively. Twenty‐one (30%) patients met the metabolic syndrome (MS) criteria. Patients with MS had lower eGDR compared to patients without (5.17 [3.10–8.65] vs. 8.86 [6.82–9.85] mg/kg/min, respectively, p = .003). Median eGDR in patients with nephropathy, retinopathy and neuropathy compared with those without was 6.75 (4.60–8.20) versus 9.53 (8.57–10.3); p < .001, 6.45 (4.60–7.09) versus 9.50 (8.60–10.14); p < .001, 5.56 (4.51–6.81) versus 9.49 [8.19–10.26] mg/kg/min; p < .001, respectively. The eGDR showed an area under the curve of 0.909, 0.879, 0.897 and 0.836 for the discrimination of MS, retinopathy, neuropathy and nephropathy, respectively. Conclusions Patients with T1D diabetic complications have higher insulin resistance. The eGDR discriminates patients with chronic diabetic complications and MS. While more ethnic‐specific studies are required, this study suggests the possibility to incorporate eGDR into routine diabetes care.

Safety and Efficacy of Eucaloric Very Low-Carb Diet (EVLCD) in Type 1 Diabetes: A One-Year Real-Life Retrospective Experience

“…In terms of complications, DM 1 remains one of the main risk factors for the development of microangiopathies [ 9 ]—such as retinopathy, nephropathy, and neuropathy—and represents a major cardiovascular risk factor for the development of vasculopathy, coronary heart disease, stroke and early cardiovascular death [ 9 , 10 ]. Furthermore, the issue of acute DM 1 complications—such as hypoglycemia [ 11 , 12 ] and diabetic ketoacidosis [ 13 ] remains unsolved.…”

Epigallocatechin Gallate Induces the Demethylation of Actinin Alpha 4 to Inhibit Diabetic Nephropathy Renal Fibrosis via the NF-KB Signaling Pathway In Vitro

“… 1 Early morphological abnormalities are characterized by glomerular hypertrophy, thickening of the glomerular basement membrane, and production of mesangial extracellular matrix, which develops into glomerulosclerosis and tubulointerstitial fibrosis, eventually leading to kidney failure. 2 , 3 Therefore, determining the key mechanism of DN development and developing an effective treatment method for delaying or halting DN progression is crucial. Recently, mounting evidence has demonstrated that the mechanism of DN is related to genetic abnormalities and epigenetic changes.…”