Clear evidence of the association between insulin resistance and progression to type 1 diabetes
Document Actions
To determine whether co-existing insulin resistance is a risk factor for developing type 1 diabetes in autoantibody positive first-degree relatives of diabetic family members, 186 subjects with a projected 25% to 50% risk for type 1 diabetes and 170 subjects with a projected >50% risk for type 1 diabetes in five years were followed to clinical diabetes onset or to the end of the study. Insulin secretion with first phase insulin response (FPIR) and insulin resistance with HOMA-R from the intravenous glucose tolerance test were assessed. Adjusted multivariate analysis revealed that HOMA-R and FPIR/HOMA-R ratio were significantly associated with type 1 diabetes in both risk groups. In the moderate risk group, the hazard ratio of HOMA-R was 2.70 and that of FPIR/HOMA-R 0.32; in the high risk group, the corresponding figures were 1.83 and 0.56, respectively. Thus insulin resistance was clearly associated with progression of type 1 diabetes. In their conclusion, the authors propose that the combination of FPIR and HOMA-R be used as a better metabolic indicator for predicting type 1 diabetes in patients at high risk due to the combined presence of first-degree relatives with type 1 diabetes and beta-cell autoantibodies.
Abstract
