Relation between HOMA-IR and insulin sensitivity index determined by hyperinsulinemic-euglycemic clamp analysis during treatment with a sodium-glucose cotransporter 2 inhibitor

Abstract

We had aimed to determine whether homeostasis model assessment-insulin resistance (HOMA-IR) reflects insulin resistance-sensitivity during treatment with a sodium-glucose cotransporter 2 inhibitor (SGLT2i). Hyperinsulinemiceuglycemic clamp analysis was performed in 22 patients with type 2 diabetic patients taking dapagliflozin (5 mg/day before or after breakfast). Propensity score matching of these individuals (SGLT2i group) for age, sex, body mass index, and clampderived tissue glucose uptake rate with 44 type 2 diabetic patients who had undergone clamp analysis without SGLT2i treatment (control group) identified 17 paired subjects in each group for further analysis of the relation between HOMA-IR and a clamp-derived insulin sensitivity index (ISI). Natural log-transformed HOMA-IR was negatively correlated with ISI in both SGLT2i (r =-0.527, p = 0.030) and control (r =-0.534, p = 0.027) groups. The simple regression lines for logtransformed HOMA-IR and ISI in the two groups showed similar slopes but differed in their intercepts. Multivariate analysis revealed that HOMA-IR for patients with the same ISI in the two groups was related by the formula: HOMA-IR control = HOMA-IR SGLT2i × 2.45. In conclusion, HOMA-IR was well correlated with ISI during SGLT2i treatment, but values corresponding to the same ISI were lower in the SGLT2i group than in the control group.

Perinatal maternal chronic exposure to dibutyl phthalate promotes visceral obesity in adult female offspring

“…The ELISA kit intra-assay coefficient of variation and inter-assay coefficient of variation were < 10% and < 12%, respectively. Homeostatic Model Assessment of estimated Insulin Resistance (HOMA-IR) was calculated based on fasting glucose and FINS (So et al, 2020).…”

SGLT2 inhibitors for genetic and acquired insulin resistance: Considerations for clinical use

“…A recent study found that HOMA‐IR and a clamp‐derived insulin sensitivity index showed a linear correlation in individuals with type 2 diabetes, even during treatment with SGLT2 inhibitor 13 , indicating that HOMA‐IR reflects insulin sensitivity, even in the presence of such drugs. However, the value of HOMA‐IR corresponding to a certain level of the clamp‐derived insulin sensitivity index was smaller in patients receiving the SGLT2 inhibitor than in control patients treated without this class of drugs 13 .…”

“…A recent study found that HOMA‐IR and a clamp‐derived insulin sensitivity index showed a linear correlation in individuals with type 2 diabetes, even during treatment with SGLT2 inhibitor 13 , indicating that HOMA‐IR reflects insulin sensitivity, even in the presence of such drugs. However, the value of HOMA‐IR corresponding to a certain level of the clamp‐derived insulin sensitivity index was smaller in patients receiving the SGLT2 inhibitor than in control patients treated without this class of drugs 13 . This finding is reasonable, given that less insulin is required during treatment with SGLT2 inhibitor not only because of a potential improvement in insulin sensitivity, but because of a reduction in the demand for glucose disposal as a result of increased urinary glucose excretion (Figure 1).…”

Effects of dapagliflozin on serum and urinary uric acid levels in patients with type 2 diabetes: a prospective pilot trial

“…SGLT2 is an active glucose transporter located in the early proximal renal tubule and accounts for 90% of glucose reabsorption by the kidneys, the expression of which is increased in both animal models of diabetes and patients with diabetes. SGLT2 inhibitors exert hypoglycemic effects by increasing urine glucose excretion in an insulin-independent way [ 2 ]. Currently, a variety of SGLT2 inhibitors have been marketed around the world with gradually increasing clinical application.…”