Estimated insulin sensitivity in Type 1 diabetes adults using clinical and research biomarkers.

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  • Additional Information
    • Source:
      Publisher: Elsevier Scientific Publishers Country of Publication: Ireland NLM ID: 8508335 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-8227 (Electronic) Linking ISSN: 01688227 NLM ISO Abbreviation: Diabetes Res Clin Pract Subsets: MEDLINE
    • Publication Information:
      Publication: 1993- : Limerick : Elsevier Scientific Publishers
      Original Publication: Amsterdam : Elsevier Science Publishers B.V., c1985-
    • Subject Terms:
      Biomarkers/*blood ; Diabetes Mellitus, Type 1/*drug therapy ; Glucose Clamp Technique/*methods ; Insulin/*therapeutic use ; Insulin Resistance/*physiology; Adult ; Female ; Humans ; Insulin/pharmacology ; Male ; Middle Aged ; Young Adult
    • Abstract:
      Aims: Insulin resistance in people with type 1 diabetes (T1D) is associated with increased risk of chronic complications and death. The gold standard to quantify insulin sensitivity, a euglycaemic hyperinsulinaemic clamp, is not applicable to clinical practice. We have employed clamp studies to develop a panel of formulae to estimate insulin sensitivity in adults with T1D for use in clinical practice and trials.
      Methods: Clamps were conducted in 28 adults with T1D, who were also characterised with 38 clinical and research biomarkers. Exhaustive search analysis was used to derive equations correlating with clamp-quantified glucose disposal rate (GDR), GDR/plasma insulin (M/I) and log 10 M/I.
      Results: Measured insulin sensitivity correlated with BMI, WHR, HDL-C, adipokines and inflammation markers on univariate analysis. Exhaustive search analysis derived three formulae correlating with clamp-derived GDR and logM/I (p < 0.0001), accounting for ≈62% of their variability. A formula using gender, age, HDL-C, pulse pressure and WHR performed as well as those containing inflammation and adipokine measures.
      Conclusions: The performance of formulae using routinely available parameters with/without research biomarkers in clinical studies and trials, particularly related to future complications, relevant lifestyle interventions, insulin delivery modes and insulin sensitisers is merited.
      Competing Interests: Declaration of Competing Interest AJJ, DNO and ASJ were investigators on the REMOVAL trial of metformin in Type 1 diabetes trial. No conflicts of interest from other authors.
      (Crown Copyright © 2020. Published by Elsevier B.V. All rights reserved.)
    • Contributed Indexing:
      Keywords: Euglycaemic hyperinsulinaemic clamp; Insulin resistance; Insulin sensitivity; Type 1 diabetes; eGDR
    • Accession Number:
      0 (Biomarkers)
      0 (Insulin)
    • Publication Date:
      Date Created: 20200804 Date Completed: 20201103 Latest Revision: 20201103
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.diabres.2020.108359
    • Accession Number:
      32745699