Insulin resistance is more frequent in type 1 diabetes patients with long disease duration

Abstract

AimsTo investigate the clinical status of insulin resistance (IR) and its correlation with disease duration in patients with type 1 diabetes (T1D).Materials and MethodsCross‐sectional data from a T1D cohort were obtained (n = 923). IR‐related metabolic disorders including hypertension, obesity, and dyslipidemia were used as outcome variables to explore the cut‐off point for estimated glucose disposal rate (eGDR) by restricted cubic spline (RCS) curve. Regression models were used for multivariate analysis of the clinical factors associated with IR. The correlation between the status of IR and diabetes duration was depicted with the RCS curve.ResultsIR‐related metabolic disorders were observed in 39.4% of patients, with 9.1% meeting the criteria for metabolic syndrome. Specifically, patients with ≥10 years of T1D were more likely to have IR‐related metabolic disorders (54.7% vs. 36.9%, p < 0.05). The presence of IR, defined as an eGDR ≤9.0 mg/kg/min, was observed in 42.2% of patients. Patients with IR had a longer diabetes duration (3.5 vs. 2.7, years, p = 0.003) and higher insulin dose (0.5 vs. 0.4, units per kg per day, p < 0.001). Moreover, the presence of IR showed a gradual increase during 10 years' disease duration and further analysis showed that diabetes duration ≥10 years was a key element behind the development of IR and IR‐related metabolic disorders.ConclusionsThe status of IR is common in T1D patients, especially in those with ≥10 years of disease duration. Therapies targeting balancing glycaemic control and IR are needed to decrease the future risk of cardiovascular diseases in T1D.Clinical trial registration: ClinicalTrials.gov NCT03610984 (cohort study of patients with type 1 diabetes).

Insulin resistance-related features are associated with cognitive decline: a cross-sectional study in adult patients with type 1 diabetes

“…Subcutaneous insulin administration rather than the physiological portal vein delivery, is another additional factor in the development of IR in T1D [ 23 ]. The prevalence of IR in T1D varies between 3 ~ 50% depending on study population and diagnostic criteria, and the IR status of our participants was similar to that reported in the Chinese population [ 11 ]. The increasing trend of IR in T1D is consistent across all measurements, and double diabetes will possibly become the predominant phenotype in T1D in the next few decades [ 8 ].…”

“…Metabolic abnormalities, including obesity, atherogenic dyslipidemia, hypertension, metabolic syndrome as well as specific calculators are often used as clinical surrogates to represent IR [ 10 ]. A 3 ~ 50% prevalence of IR in T1D patients has been reported based on these surrogate assessments, which is higher than that in the general population [ 11 ] and can well predict the risk of chronic diabetic complications [ 8 ].…”

The Role of Helicobacter pylori and Metabolic Syndrome-Related Mast Cell Activation Pathologies and Their Potential Impact on Pregnancy and Neonatal Outcomes

“…Additionally, higher galectin-3 levels are independently connected with depression in type 1 DM [73]. Type 1 DM is also associated with MetS [74,75] and H. pylori infection [76]. It is noteworthy that galectin-3, apart from its presence in other cell types, is also found in MCs, though the potential role of galectin-3-related MC activation in conditions such as C-CVD remains to be elucidated [71].…”