scholarly journals Comparison of Insulin Resistance in Lean and Obese Adults with Type 2 Diabetes Mellitus- A Cross-sectional Study

2020 ◽  
Author(s):  
Sandinti Deepa ◽  
V Lakshmaiah ◽  
K Prabhakar ◽  
A Raveesha ◽  
CR Vidyasagar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Fasting Insulin ◽  
Obese Adults ◽  
Cross Sectional ◽  
Univariate Logistic Regression Analysis ◽  
C Peptide

Introduction: Insulin Resistance (IR) can develop into type 2 diabetes mellitus and is closely associated with obesity. However, the non-obese population has also shown a predisposition to the risk of IR due to genetics. Aim: To assess the relationship between IR and obesity in Type 2 Diabetes Mellitus (T2DM) by comparing the proportion of subjects with IR in lean and obese T2DM and to identify the factors predicting IR in T2DM. Materials and Methods: A cross-sectional, hospital-based study was done at Department of Medicine of RL Jalappa hospital, Kolar, Karnataka on 106 T2DM patients aged >18 years. The study population was grouped into lean (BMI <19 kg/m2) and obese adults (BMI >30 kg/m2). IR was calculated using Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) and was considered as primary outcome variable. Obesity was considered as primary explanatory variable. Age, Gender, fasting insulin, C-peptide, Fasting Blood Sugar, Glycated haemoglobin (GHB or HbA1c) were the other explanatory variables. Descriptive analysis was carried out using mean and standard deviation for quantitative variables, frequency and proportion for categorical variables. Chi-square test was used to test statistical significance between the groups. Univariate logistic regression analysis was done to identify the predictors of IR. IBM Statistical Package for Social Sciences (SPSS) version 22 was used for statistical analysis. The p-value <0.05 was considered to be statistically significant. Results: The 106 subjects involved in the study had a mean age of 53.88±9.21 years. 44 subjects (41.5%) had IR. Obese to lean diabetic patients were in the ratio of 1:4. The proportion of obese diabetic subjects was (n=84, 79.2%) whereas lean diabetics were (n=22, 20.8%). The proportion of obese diabetic subjects with IR was 38.1% while the proportion of lean diabetic subjects with IR was 54.55%, but this difference was statistically not significant (p=0.163). On univariate logistic regression analysis, fasting insulin (odds ratio of 2.442 with 95% CI of 1.665 to 3.851, p<0.001**) and C-peptide (odds ratio of 1.446 with 95% CI of 1.123, p=0.004) were statistically significant factors attributing to IR. Conclusion: There was no significant relationship between IR and obesity. IR was independently associated with Fasting insulin levels and C-peptide levels.

scholarly journals The association of anthropometric parameters with markers of insulin and leptin secretion and resistance in type 2 diabetes mellitus

2020 ◽  
Vol 28 (3) ◽  
pp. 299-314
Author(s):  
Simona Cernea ◽  
Emőke Both ◽  
Adriana Fodor
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Secretion ◽  
Diabetes Duration ◽  
Leptin Resistance ◽  
Anthropometric Parameters ◽  
C Peptide

AbstractAim: We evaluated the association between anthropometric parameters and markers of insulin and leptin secretion/resistance in patients with type 2 diabetes mellitus (T2DM).Material and methods: This post-hoc data analysis from a cross-sectional study included 176 T2DM patients. Laboratory tests (serum leptin, soluble form of leptin receptor (sObR), C peptide, glycemic and lipid parameters) and anthropometric parameters were obtained, adiposity indexes (including body adiposity index (BAI), visceral adiposity index (VAI)), indicators of insulin resistance, β-cell function, and leptin resistance (Free Leptin Index, FLI) were calculated.Results: The body mass index (BMI), diabetes duration, VAI and leptin correlated independently with HOMA-IR, while BMI, diabetes duration and HbA1c with HOMA-B. The total body fat mass (TBFM), C peptide, diabetes duration, BMI and BAI correlated with leptin concentrations, while the first three with FLI. VAI was an indicator of insulin resistance (β=0.166, p=0.003), while BAI of leptin secretion (β=0.260, p=0.010). TBFM strongly associated with leptin resistance and secretion (β=0.037, r=0.688, p<0.0001, and β=0.521, r=0.667, p<0.0001), and BMI correlated weakly with insulin secretion and resistance. While insulin and leptin secretion increased progressively with BMI, leptin and insulin resistance became significant only in case of obesity. The sObR was significantly associated with C peptide concentrations (β=-0.032; p=0.044), but not with HOMA-B or -IR. A strong positive correlation between the C peptide/leptin ratio and non-fat mass /TBFM ratio was noted (r=0.62 [0.52, 0.71], p<0.0001).Conclusions: Parameters of peripheral adiposity correlated better with markers of leptin system, and those of visceral adiposity with markers of insulin secretion/resistance. The sObR correlated independently and negatively with C peptide.

scholarly journals A study of insulin resistance and pancreatic beta cell function in diabetics and non-diabetics

Biomedicine ◽  
2020 ◽  
Vol 39 (3) ◽  
pp. 497-502
Author(s):  
Mary Chandrika A. ◽  
B. Shanthi
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Family History ◽  
Pancreatic Beta Cell ◽  
Family History Of Diabetes ◽  
C Peptide ◽  
History Of

Introduction and Aim: The most common non-communicable disease affecting large population is type 2 diabetes mellitus. This metabolic disorder is characterized by hyperglycemia with disturbances of carbohydrate, fat and protein metabolism. The causes of diabetes mellitus can vary greatly but always include either defects in insulin secretion of the pancreas or the cells of the body not responding properly to the insulin produced or in both at some point in the course of the disease. Materials and Methods: 200 participants who were divided into two groups, non-diabetics with and without family history of diabetes were involved in this study. The outcomes of fasting plasma glucose, postprandial plasma glucose, glycated hemoglobin, fasting plasma insulin, serum c-peptide, HOMA -IR, HOMA-B were compared between both the groups. Results: All these parameters were significantly correlated between the groups with the level of significance p<0.05%. Non-diabetic off-springs of type 2 diabetes were found to have hyperinsulinemia, increased level of serum c-peptide level, moderate insulin resistance and pancreatic beta cell dysfunction than non-diabetics without the family history of diabetes. The fasting hyperinsulinemia, known to reflect decreased insulin sensitivity constitute the strongest independent predictor of type 2 diabetes. Conclusion: The above findings show that insulin resistance is the primary abnormality in type 2 Diabetes Mellitus.

scholarly journals Uric Acid Levels in Type 2 Diabetes Mellitus Patients

2021 ◽  
Vol 3 (2) ◽  
pp. 83-89
Author(s):  
Linda Ramadhanti ◽  
Devi Etivia Purlinda
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Uric Acid ◽  
Acid Value ◽  
Cross Sectional ◽  
Type 2 Dm ◽  
Exercise Activity

Type 2 diabetes mellitus accounts for about 90% of all diabetes cases worldwide. Type 2 DM is caused by the body's inability to respond well to insulin or called insulin resistance. Insulin resistance causes hyperglycemia and hyperinsulinemia which results in decreased uric acid excretion function in the kidney tubules, so that there will be an increase in uric acid in the blood or hyperuricemia. Type of research including descriptive with cross sectional approach. The examination was carried out at Dr. Adhyatma, MPH. The research respondents were 24 people, uric acid levels were examined with a TMS 50i Superior device. The data obtained is processed and presented in the form of diagrams and percentages. Type 2 DM respondents numbered 24 people. The highest hyperuricemia is based on the characteristics of the respondents, those are above 55 years old (25%), female sex (25%), high blood pressure (25%), and exercise activity 1x / day (21%). Of the 24 respondents, 14 people (58.3%) had normal uric acid levels and 10 people (41.6%) had hyperuricemia, with an average female uric acid value of 5.54 mg / dL and men of 6,48 mg / dL.

scholarly journals SLC22A1 rs622342 Polymorphism Predicts Insulin Resistance Improvement in Patients with Type 2 Diabetes Mellitus Treated with Metformin: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Kunrong Wu ◽  
Xiaoli Li ◽  
Yuedong Xu ◽  
Xiaoqian Zhang ◽  
Ziwan Guan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cell Function ◽  
Cross Sectional Study ◽  
Model Assessment ◽  
Sectional Study ◽  
Cross Sectional

Background. Metformin is the most widely used oral antidiabetic agent and can reduce insulin resistance (IR) effectively. Organic cation transporter 1 (encoded by SLC22A1) is responsible for the transport of metformin, and ataxia-telangiectasia-mutated (ATM) is a gene relating to the DNA repair and cell cycle control. The aim of this study was to evaluate if the genetic variants in SLC22A1 rs622342 and ATM rs11212617 could be effective predictors of islet function improvement in patients with type 2 diabetes mellitus (T2DM) on metformin treatment. Methods. This cross-sectional study included 111 patients with T2DM treated with metformin. Genotyping was performed by the dideoxy chain-termination method. The homeostatic indexes of IR (HOMA-IR) and beta-cell function (HOMA-BCF) were determined according to the homeostasis model assessment. Results. Fasting plasma glucose (FPG) levels, HbA1c levels, and HOMA-IR were significantly higher in patients with the rs622342 AA genotype than in those with C allele (P<0.05). However, these significant differences were not observed between rs11212617 genotype groups. Further data analysis revealed that the association between the rs622342 polymorphism and HOMA-IR was gender related, and so was rs11212617 polymorphism and HOMA-BCF. HOMA-IR was significantly higher in males with rs622342 AA genotype than in those with C allele (P=0.021), and HOMA-BCF value was significantly higher in females carrying rs11212617 CC genotype than in those with A allele (P=0.038). The common logarithm (Lg10) of HOMA-BCF was positively correlated with the reciprocal of HbA1c (r = 0.629, P<0.001) and negatively associated with Lg10 FPG (r = −0.708, P<0.001). Conclusions. The variant of rs622342 could be a predictor of insulin sensitivity in patients with T2DM treated with metformin. The association between the rs622342 polymorphism and HOMA-IR and the association between the rs11212617 polymorphism and HOMA-BCF were both gender related.

scholarly journals Correlation of Surrogate Markers of Insulin Resistance with Fasting Insulin in Type 2 Diabetes Mellitus Patients: A Study of Malwa Population in Punjab, India

2021 ◽  
Author(s):  
Navneet Kaur ◽  
Gitanjali Gitanjali ◽  
Ravinder Garg ◽  
Chaitanya Tapasvi ◽  
Sonia Chawla ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Statistical Analysis ◽  
Surrogate Markers ◽  
Fasting Insulin ◽  
Kappa Test ◽  
Type 2 Dm

Abstract Context Insulin resistance (IR) and abnormal insulin secretion play a key role for the development of type 2 diabetes mellitus (DM). Aims We investigated the surrogate markers of IR, i.e., Homeostasis Model Assessment (HOMA), Quantitative Insulin Sensitivity Check Index (QUICKI), McAuley, and Fasting Insulin Resistance Index (FIRI) in type 2 DM patients. Also, fasting insulin (FI) levels were estimated in type 2 diabetics. Further, the correlation of FI with other surrogate markers of IR in type 2 DM was done. Settings and Design A hundred newly diagnosed patients with type 2 DM from Malwa population, Punjab, were considered for evaluation. Another 100 healthy individuals (age and sex-matched) were examined as controls. Methods and Material Fasting blood glucose, FI, and lipid profile were estimated, and IR was calculated using McAuley index (McA), HOMA, QUICKI, and FIRI. Statistical Analysis Used The statistical analysis was performed on the above-mentioned clinical interpretations. The Cohen’s kappa test was used to affirm the agreement. Results FI levels in patients with type 2 diabetes were significantly higher (20.8 ± 9.05 µIU/L) than controls (7.93 ± 1.01 µIU/L). IR by surrogate markers was found significant in the study group. The 76% patients with type 2 diabetes ended up as resistant to insulin by FI measurement, almost equivalent to McA, 80%; HOMA, 88%; FIRI, 88%; and QUICKI, 90%. A notable correlation was highlighted between FI and McA manifesting IR (p < 0.01, r = −0.85). We calculated the statistical correlation of FI with HOMA, QUICKI, and FIRI indices (p < 0.01, r = 0.93; p < 0.01 r = −0.92; and p < 0.01, r = +0.93, respectively). The agreement visible from Cohen’s kappa test also affirms the same (k = 0.9 for McA). Conclusion We concluded that all the surrogate markers for IR were specific when compared with FI, but in terms of sensitivity McA was found to be more sensitive as it includes markers of dyslipidemia, which is the precipitating factor of metabolic derangements so as the IR in type 2 DM.

scholarly journals Investigation of leucinuria as a marker of progression of type 2 diabetes mellitus

2019 ◽  
Vol 8 (1) ◽  
pp. 32-36
Author(s):  
Kabita Khaniya Pokharel ◽  
Santosh Pradhan
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
High Performance ◽  
Cross Sectional Study ◽  
Chromatography Method ◽  
Cross Sectional ◽  
Ethical Approval

Background: The prevalence of diabetes is increasing worldwide leading to an extreme burden in healthcare system. Insulin resistance plays a major role in the pathogenesis of type 2 diabetes mellitus. A number of studies have been done to investigate the role of leucine in insulin resistance. These studies have elucidated raised serum leucine level in type 2 diabetes mellitus. Objectives: The objective of this study was to determine leucine in random urine of type 2 diabetes mellitus and to assess the association of urine leucine with the progression of the disease. Methodology: An analytical cross-sectional study was carried out in 187 participants after ethical approval. Patients already diagnosed with chronic kidney disease were excluded from the study. Urine microalbumin level was determined by nephelometry technique, HbA1c test was done by high performance liquid chromatoghrapy and urine leucine was detected by thin layer chromatography method. Results: The mean age of the case population was 55.7±11.6 years and that of control population was 49.98±13.7 years. Out of 105 cases, 15 (14.3%) of them had leucine in random urine where as only 3 (3.6%) of them from control showed the presence of leucine in their urine. There was a significant association observed between diabetic patient and urinary leucine excretion, P = 0.014. Conclusion: This study indicates an association of type 2 diabetes and urinary leucine excretion. However, presence of leucine in urine does not suggest the progression of the disease.

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