Can clinical factors estimate insulin resistance in type 1 diabetes?
Open accessAbstract
An insulin resistance syndrome (IRS) score was developed based on clinical risk factors in adults with childhood-onset type 1 diabetes in the Epidemiology of Diabetes Complications (EDC) Study and was validated using euglycemic-hyperinsulinemic clamp studies. Hypertension, waist-to-hip ratio (WHR), triglyceride and HDL cholesterol levels, family history of type 2 diabetes, and glycemic control were risk factors used to define the score. A score of 1 (lowest likelihood IRS) to 3 (highest likelihood IRS) was assigned for each risk factor. Eligible subjects (n = 24) were recruited from the EDC cohort based on tertile of IRS score. Subjects received an overnight insulin infusion to normalize glucose levels, then underwent a 3-h euglycemic-hyperinsulinemic (60 mU x m(-2) x min(-1)) clamp. Glucose disposal rate (GDR) was determined during the last 30 min of the clamp. The GDR differed significantly by IRS group (9.65 +/- 2.99, 8.02 +/- 1.39, and 5.68 +/- 2.16 mg x kg(-1) x min(-1), P < 0.01). The GDR was inversely correlated with the IRS score (r = -0.64, P < 0.01). Using linear regression, the combination of risk factors that yielded the highest adjusted r2 value (0.57, P < 0.001) were WHR, hypertension, and HbA1. This study found that clinical risk factors can be used to identify subjects with type 1 diabetes who are insulin resistant, and it provides validation of a score based on clinical factors to determine the extent of insulin resistance in type 1 diabetes. This score will be applied to the entire EDC population in future studies to determine the effect of insulin resistance on complications.
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In men with type 1 diabetes, calculated free testosterone levels were independently associated with eGDR, a marker of insulin sensitivity, after adjusting for age (P=0.04).
“In men with type 1 diabetes, cFT levels were also independently associated with eGDR, a marker of insulin sensitivity in individuals with type 1 diabetes (24), after adjusting for age (P ϭ 0.04).”
From Low testosterone levels are common and associated with insulin resistance in men with diabetes (2008) · cites this paper as [24]
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“Insulin sensitivity was determined by a previously validated estimated glucose disposal rate (eGDR) regression equation [36].”
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Progression of Coronary Artery Calcium in Type 1 Diabetes Mellitus
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- Authors
- Williams, K. V., Erbey, J. R., Becker, D., Arslanian, S., & Orchard, T. J.
- Affiliations
- University of Pittsburgh (US)
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2000-04-01
- Volume
- 49
- Issue
- 4
- Pages
- 626-632
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2143570364
- Cited by
- 640
- References
- 11
- Citations by year
- 2026: 66 · 2025: 94 · 2024: 47 · 2023: 42 · 2022: 38 · 2021: 39 · 2020: 27 · 2019: 15 · 2018: 26 · 2017: 16 · 2016: 17 · 2015: 23 · 2014: 22 · 2013: 25 · 2012: 16
- FWCI
- 4.53
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (2 T32 DK07052-22, T32DK007052)
- National Center for Research Resources (5M01-RRR00084)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- insulin resistance, type 1 diabetes, childhood-onset diabetes, clinical risk factors, waist-to-hip ratio, hypertension, glycemic control, HbA1c, glucose disposal rate, hyperinsulinemic-euglycemic clamp
- MeSH terms
- Adult, Blood Glucose, Blood Pressure, Body Constitution, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Insulin, Insulin Resistance, Cholesterol, HDL, Male, Middle Aged, Risk Factors, Triglycerides, Glucose Clamp Technique, Logistic Models
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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