February 2017 Vol. 5 No.2

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Original Research Article

Surrogate Measures of Insulin Sensitivity in Type 2 Diabetic Patients Useful in Clinical Practice

Petya Kamenova

Department of Diabetology, Clinical Center of Endocrinology and Gerontology, Medical University, Sofia, Bulgaria

kamenovap@abv.bg

Accepted February 13, 2017

Abstract

Insulin resistance or reduced insulin sensitivity is a key pathogenetic defect of type 2 diabetes mellitus and well established cardiovascular risk factor. The determination of insulin sensitivity and identification of insulin resistant individuals could improve their cardiovascular prognosis by effective treatment. The aim of the study was to elucidate easily applicable in routine clinical practice surrogate measures of insulin sensitivity, determining the highest percent of its variation in type 2 diabetic patients (T2D pts). Sixty three T2D pts of mean age 52.0±8.7 yrs, in good glycaemic control (glycated hemoglobin 6.38±0.58%) on a diet and oral antidiabetic drugs, participated in a cross-sectional study. The quantification of insulin sensitivity was done by the “gold standard”- a manual hyperinsulinaemic euglycaemic clamp technique and expressed as a glucose disposal rate (M, mg/kg/min). Stepwise multiple linear regression analysis elucidated waist circumference (WC) as an independent predictor of insulin sensitivity in diabetic women explaining 50.5% of its variation. In diabetic men predictors of insulin sensitivity were WC and diastolic blood pressure explaining 60.4% of its variation. This study determined surrogate measures of insulin sensitivity which are easily applicable in routine clinical practice, allowing physicians to identify and treat patients with insulin resistance effectively for a reduction of cardiovascular risk.

Key words: Cardiovascular risk, Hyperinsulinaemic Euglycaemic Clamp Technique, Insulin Resistance, Insulin Sensitivity, Type 2 Diabetes Mellitus, Waist circumference