Asprosin response in hypoglycemia is not related to hypoglycemia unawareness but rather to insulin resistance in type 1 diabetes

The recurrence of hypoglycemic episodes leads to attenuation of the normal counter-regulatory mechanisms that are controlled by the hypothalamus, which results in hypoglycemia unawareness (HU). In this case report, we described for the first time the differential expression of TNF-α, IL-1β, IL-6, and IFN-γ in a blood sample that was taken from a 27-year-old patient with type 1 diabetes mellitus (T1DM) who was diagnosed with HU. The anti-diabetic regimen is currently based on insulin injection, but the patient is planning to start the use of an insulin pump to have better control of glucose levels. Our results showed a trend toward an increase in the expression of IL-1β, IL-6, and IFN-γ in T1DM patient with HU. However, the mRNA level of TNF-α showed a significant decrease. These observations suggest that systemic inflammation could be an underlying cause of HU.

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Insulin resistance is a risk factor for progression to Type 1 diabetes

Diabetologia ◽

10.1007/s00125-004-1621-2 ◽

2004 ◽

Vol 47 (12) ◽

pp. 2247-2247

Author(s):

S. Fourlanos ◽

P. Narendran ◽

G. B. Byrnes ◽

P. G. Colman ◽

L. C. Harrison

Keyword(s):

Insulin Resistance ◽

Type 1 Diabetes ◽

Risk Factor

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Insulin Resistance in Type 1 Diabetes of Long Duration

Clinical Science ◽

10.1042/cs070019pa ◽

1986 ◽

Vol 70 (s13) ◽

pp. 19P-19P

Author(s):

B.M. Singh ◽

M. Nattrass

Keyword(s):

Insulin Resistance ◽

Type 1 Diabetes ◽

Long Duration

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Insulin resistance is associated with cognitive decline in type 1 diabetes mellitus

Acta Diabetologica ◽

10.1007/s00592-021-01846-z ◽

2022 ◽

Author(s):

Yuanjie Mao ◽

Wenjun Zhong

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 1 Diabetes ◽

Cognitive Decline ◽

Type 1 Diabetes Mellitus

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Insulin resistance and risk of vascular events, interventions and mortality in type 1 diabetes

Acta Endocrinologica ◽

10.1530/eje-21-0636 ◽

2021 ◽

Author(s):

Marga A.g. Helmink ◽

Marieke de Vries ◽

Frank L.j. Visseren ◽

Wendela L. de Ranitz ◽

Harold W. de Valk ◽

...

Keyword(s):

Insulin Resistance ◽

Cardiovascular Disease ◽

Type 1 Diabetes ◽

Insulin Sensitivity ◽

Lower Risk ◽

Cardiovascular Events ◽

Additional Risk Factor ◽

Vascular Events ◽

All Cause Mortality

Objective: To identify determinants associated with insulin resistance and to assess the association between insulin resistance and cardiovascular events, vascular interventions and mortality in people with type 1 diabetes at high risk of cardiovascular disease . Design: Prospective cohort study. Methods: 195 people with type 1 diabetes from the Secondary Manifestations of ARTerial disease (SMART) cohort were included. Insulin resistance was quantified by the estimated glucose disposal rate (eGDR) with higher eGDR levels indicating higher insulin sensitivity (i.e. lower eGDR levels indicating higher insulin resistance). Linear regression models were used to evaluate determinants associated with eGDR. The effect of eGDR on cardiovascular events, cardiovascular events or vascular interventions (combined endpoint) and on all-cause mortality was analysed using Cox proportional hazards models adjusted for confounders. Results: In 195 individuals (median follow-up 12.9 years, IQR 6.7-17.0), a total of 25 cardiovascular events, 26 vascular interventions and 27 deaths were observed. High eGDR as a marker for preserved insulin sensitivity was independently associated with a lower risk of cardiovascular events (HR 0.75; 95%CI 0.61-0.91), a lower risk of cardiovascular events and vascular interventions (HR 0.74; 95%CI 0.63-0.87), and a lower risk of all-cause mortality (HR 0.81; 95%CI 0.67-0.98). Conclusions: Insulin resistance as measured by eGDR is an additional risk factor for cardiovascular disease in individuals with type 1 diabetes. Modification of insulin resistance by lifestyle interventions or pharmacological treatment could be a viable therapeutic target to lower the risk of cardiovascular disease.

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