Use of the Estimated Glucose Disposal Rate as a Measure of Insulin Resistance in an Urban Multiethnic Population With Type 1 Diabetes
| العنوان: | Use of the Estimated Glucose Disposal Rate as a Measure of Insulin Resistance in an Urban Multiethnic Population With Type 1 Diabetes |
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| المؤلفون: | Jamie L. Osman, Oksana Lewis, Jill P. Crandall, Swapnil Rajpathak, Hillel W. Cohen, Eric J. Epstein |
| المصدر: | Diabetes Care |
| بيانات النشر: | American Diabetes Association, 2013. |
| سنة النشر: | 2013 |
| مصطلحات موضوعية: | Adult, Male, Gerontology, medicine.medical_specialty, Waist, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Population, Black People, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, White People, Diabetes Complications, 03 medical and health sciences, 0302 clinical medicine, Insulin resistance, Internal medicine, Diabetes mellitus, Ethnicity, Internal Medicine, medicine, Humans, Epidemiology/Health Services Research, education, Original Research, Glycated Hemoglobin, Advanced and Specialized Nursing, Type 1 diabetes, education.field_of_study, business.industry, Hispanic or Latino, Odds ratio, Middle Aged, medicine.disease, 3. Good health, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Glucose, Hypertension, Albuminuria, Female, New York City, Insulin Resistance, Waist Circumference, medicine.symptom, business |
| الوصف: | OBJECTIVE Insulin resistance has been described in type 1 diabetes mellitus, is related to risk of vascular complications, and may be more common in certain ethnic groups. Estimated glucose disposal rate (eGDR) is a validated clinical tool for estimating insulin sensitivity in type 1 diabetes. Because previous reports of eGDR in adults with type 1 diabetes have included few ethnic minorities, this study explored interethnic differences in eGDR and the relationship of eGDR with diabetic vascular complications. RESEARCH DESIGN AND METHODS We conducted a cross-sectional study using a sample that included 207 white, black, or Hispanic adults with prior clinical diagnosis of type 1 diabetes who were receiving care at an urban academic medical center. eGDR (milligrams per kilogram per minute) was calculated using HbA1c, waist circumference, and hypertensive status. Race/ethnicity was self-reported. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% CIs of association of eGDR with diabetes complications (cardiovascular disease, retinopathy, albuminuria, and chronic kidney disease above stage 3). RESULTS Forty-two percent of the participants were women, and mean age was 45 ± 15 years; 34% were white, 32% were Hispanic, and 34% were black. Ethnicity was significantly associated with eGDR; blacks had significantly lower eGDR (5.66 ± 2.34) than Hispanics (6.70 ± 2.29) and whites (7.20 ± 2.03) (P < 0.001). Patients with the lowest eGDR compared with the highest had a significantly greater risk of any diabetes complication (OR 3.1 [95% CI 1.2–8.1]) compared with the least insulin-resistant patients. CONCLUSIONS In an urban clinic population of patients with type 1 diabetes, blacks were significantly less insulin sensitive than whites or Hispanics, and lower eGDR was associated with diabetes complications. Further study is needed to determine whether using eGDR to target interventions can improve outcomes. |
| تدمد: | 1935-5548 0149-5992 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b1618f8dafe2a784f8fb6143252e1973Test https://doi.org/10.2337/dc12-1693Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b1618f8dafe2a784f8fb6143252e1973 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19355548 01495992 |
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