Insulin action and secretion independent of traditional risk factors predict new‐onset type 2 diabetes in Iraqi and Swedish born citizens – The MEDIM cohort study

Abstract

Aims Our aim was to study the incidence of type 2 diabetes in a population‐based cohort of Swedish and Iraqi born individuals, focussing on traditional risk factors, insulin action, insulin secretion and ethnicity. Materials and Methods The cohort consisted of 1164 Iraqi and 693 Swedish‐born citizens. We investigated the association between new‐onset type 2 diabetes and the predictors including lifestyle factors, metabolic risk markers, country of birth, insulin sensitivity and secretion assessed by Matsuda index with Cox regression. Results Eighty‐nine individuals were diagnosed with type 2 diabetes with a mean follow‐up of 7.5 years. Both lower insulin sensitivity (ISI, HR 0.02 [0.01–0.08]) as well as insulin secretion (CIR, HR 0.13 [0.07–0.24]) at baseline predicted type 2 diabetes onset, independent of traditional risk factors. Our results were not modified by country of birth. Regarding traditional risk factors, WHR (1.05 [1.00–1.09]), blood glucose (3.27 [2.35–4.55]), LDL/HDL (1.46 [1.20–1.78]) and diastolic blood pressure (1.04 [1.00–1.07]) predicted diabetes incidence in the full model. Conclusions Both impaired insulin sensitivity index and corrected insulin response predicted type 2 diabetes onset, independent of traditional risk factors. We conclude that insulin secretion and action might be useful additional predictors for type 2 diabetes in populations of European and Middle Eastern ethnicities.

Development and validation of a machine learning‐based model to predict isolated post‐challenge hyperglycemia in middle‐aged and elder adults: Analysis from a multicentric study

“…24,25 Recent prospective epidemiological studies have highlighted the associational effect of LDL/HDL on the prediction of type 2 diabetes onset. 26 higher AUC and accuracy than logistic regression. 27…”

“…Some studies have found an inverse relationship between the levels of HDL‐C with 2hPG and type 2 diabetes incidence 24,25 . Recent prospective epidemiological studies have highlighted the associational effect of LDL/HDL on the prediction of type 2 diabetes onset 26 . These findings were consistent with our study results, wherein our model involving FPG, HbA1c, age, heart rate, ALT, TG, LDL‐C, SBP, BMI, and HDL‐C could diagnose IPH with higher sensitivity and specificity in a population with normal FPG.…”