Insulin Resistance in Adults with Type 1 Diabetes is Associated with Lower Vitamin D Serum Concentration

Abstract Aim Type 1 diabetes mellitus (T1DM) is a disease characterized by an absolute deficiency of endogenous insulin secretion. Insulin resistance (IR) may develop among patients with T1DM. Vitamin D deficiency was reported to be a risk factor in the development of IR. The aim of the study was to assess the relationship between serum concentrations of 25-hydroxyvitamin D (25(OH)D) and IR among patients with T1DM. Methods The test group consisted of 110 adult patients [males=65 (59%)] with T1DM. Participants were recruited in Poland between 1st October and 30th April in 2015/2016 and 2016/2017. VD serum level was assessed by ELISA array. IR was assessed by estimated Glucose Disposal Rate (eGDR). Results In the study group 21 (19%) patients were recognized as IR according to eGDR cut-offs (<7.5 mg/kg/min), 52 (47.3%) patients had VD deficiency (25(OH)D<20 ng/ml), 16 (14.5%) patients had 25(OH)D<10 ng/ml. Only 6 (5%) participants reported VD supplementation. Patients with IR, according to eGDR cut-off revealed significantly lower 25(OH)D serum level 15.7 (9.2–28.4) vs. 22.1 (13.0–38.4) ng/ml; p=0.04 as compared to patients without IR. R Spearman analysis found a positive relationship between VD and eGDR (Rs=0.27; p<0.01). Logistic regression analysis revealed significant relationship between the presence of IR and VD serum level/presence of 25(OH)D serum level below 10 ng/ml, both models adjusted to sex, age, BMI, LDL and triglycerides, accordingly (OR=0.95, CI: 0.90–0.99; p=0.04) and (OR=4.19, CI: 1.04–16.93; p=0.04). Conclusion The serum concentration of Vitamin D is negatively associated with insulin resistance in patients with T1DM and may have clinical implications.

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Estimated Glucose Disposal Rate (eGDR) – A Marker for the Assessment of Insulin Resistance in Type 1 Diabetes Mellitus

Romanian Journal of Diabetes Nutrition and Metabolic Diseases ◽

10.1515/rjdnmd-2016-0021 ◽

2016 ◽

Vol 23 (2) ◽

pp. 177-182 ◽

Cited By ~ 1

Author(s):

Mihaela L. Bîcu ◽

Daniel Bîcu ◽

Sigina Gârgavu ◽

Magdalena Sandu ◽

Mihaela I. Vladu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Glucose Disposal ◽

Chronic Complications ◽

Important Indicator ◽

Estimated Glucose Disposal Rate ◽

Glucose Disposal Rate

AbstractBackground and Aims: Studies have shown an increased incidence of chronic complications in people with type 1 diabetes mellitus (T1DM) with insulin resistance (IR) compared to people with T1DM without IR. Estimated glucose disposal rate (eGDR) is an important indicator of IR in patients with T1DM, lower eGDR levels indicating greater IR. It was shown that T1DM patients with chronic complications (diabetic retinopathy - DR, diabetic peripheral neuropathy - DPN or diabetic kidney disease - DKD) exhibit higher IR compared to patients without chronic complications. The aim of our study was to evaluate eGDR as a marker for the assessment of IR in T1DM patients.Materials and Methods: The study was observational, cross-sectional and included 140 T1DM patients with diabetes duration>10 years. The collected data were analyzed using the Statistic Package for Social Sciences (SPSS) version 22 software (IBM Corporation, Armonk, NY, USA).Results: eGDR presented statistically significant correlations (p<0.05) with the presence of metabolic syndrome (MS), obesity, chronic complications of T1DM, cardiovascular risk (CVR) and smoking status in patients with T1DM duration >10 years.Conclusions: eGDR represents a reliable marker for assessing the IR in T1DM.

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Use of the Estimated Glucose Disposal Rate as a Measure of Insulin Resistance in an Urban Multiethnic Population With Type 1 Diabetes

Diabetes Care ◽

10.2337/dc12-1693 ◽

2013 ◽

Vol 36 (8) ◽

pp. 2280-2285 ◽

Cited By ~ 21

Author(s):

E. J. Epstein ◽

J. L. Osman ◽

H. W. Cohen ◽

S. N. Rajpathak ◽

O. Lewis ◽

...

Keyword(s):

Insulin Resistance ◽

Type 1 Diabetes ◽

Glucose Disposal ◽

Multiethnic Population ◽

Estimated Glucose Disposal Rate ◽

Glucose Disposal Rate

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The role of estimated glucose disposal rate as a predictor of insulin resistance, NAFLD and major adverse cardiovascular events in type 1 diabetes mellitus

Endocrine Abstracts ◽

10.1530/endoabs.73.aep11 ◽

2021 ◽

Author(s):

Jonathan Mertens ◽

Christophe De Block ◽

Eveline Dirinck ◽

Sven Francque

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 1 Diabetes ◽

Cardiovascular Events ◽

Glucose Disposal ◽

Major Adverse Cardiovascular Events ◽

Estimated Glucose Disposal Rate ◽

Glucose Disposal Rate

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Acanthosis Nigricans in Children and Adolescents with Type 1 Diabetes or Obesity: The Potential Interplay Role between Insulin Resistance and Excess Weight

Children ◽

10.3390/children8080710 ◽

2021 ◽

Vol 8 (8) ◽

pp. 710

Author(s):

Valeria Calcaterra ◽

Annalisa De Silvestri ◽

Laura Schneider ◽

Miriam Acunzo ◽

Viola Vittoni ◽

...

Keyword(s):

Insulin Resistance ◽

Type 1 Diabetes ◽

Acanthosis Nigricans ◽

Normal Weight ◽

Excess Weight ◽

Glucose Disposal ◽

Model Assessment ◽

Predisposing Factor ◽

Estimated Glucose Disposal Rate

Acanthosis nigricans (AN) is associated with obesity and type 2 diabetes, where insulin resistance (IR) is considered a predisposing factor. IR can also affect patients with type 1 diabetes (T1D). We evaluated the prevalence of AN in patients with T1D compared to subjects with obesity in order to define the interplay between IR and excess weight. We considered 138 pediatric patients who presented with T1D and 162 with obesity. As controls, 100 healthy normal-weight subjects were included. A physical examination with the detection of AN and biochemical assessments was performed. IR was calculated by using the homeostasis model assessment for IR in patients with obesity and the estimated glucose disposal rate in T1D. The AN prevalence was higher in T1D and obese subjects compared with controls in whom AN was not detected (p = 0.02 and p < 0.001, respectively). A greater number of AN cases were observed in subjects with obesity compared with T1D (p < 0.001). Patients with AN were older than subjects without AN (p = 0.005), and they had higher body mass index (BMI) values, waist circumference (WC), fasting triglycerides and blood pressure (all p < 0.001). Thirty-five patients with AN exhibited IR with an association between AN presence and IR in patients with obesity (p < 0.001). In T1D, there was an association between AN and being overweight/obese (p = 0.02), independently of IR. AN is a dermatological condition associated with obesity. In T1D, the presence of AN was significantly associated with overweight status or obesity but not IR. The presence of AN in the absence of IR supports the interplay role between impaired insulin signaling, IR and excess weight in the pathogenic mechanism.

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