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Exp Clin Endocrinol Diabetes 2010; 118(8): 478-484
DOI: 10.1055/s-0030-1249635
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Insulin Resistance is Associated with Microangiopathy in Type 1 Diabetic Patients Treated with Intensive Insulin Therapy from the Onset of Disease

A. Uruska1 , A. Araszkiewicz1 , D. Zozulinska-Ziolkiewicz1 , P. Uruski2 , B. Wierusz-Wysocka1
  • 1Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Mickiewicza, Poznan, Poland
  • 2Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Dluga, Poznan, Poland
Further Information

Publication History

received 29.12.2009 first decision 15.02.2010

accepted 24.02.2010

Publication Date:
06 April 2010 (online)

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Abstract

Aim: The aim of the study was to evaluate the relationship between indirect parameters of insulin resistance (IR) and risk of microangiopathy in patients with type 1 diabetes (DM1), treated from the initial diagnosis with intensive insulin therapy.

Methods: The study group consisted of 81 patients with DM1 (51 men, 30 women), aged 34±6.4, and who were observed for 10±1.5 years. Indirect parameters of IR were evaluated: waist circumference, waist to hip ratio (WHR), body mass index (BMI), daily insulin requirement, gain of weight from the beginning of the disease, lipid profile, estimated glucose disposal rate (eGDR), inflammatory markers and features of metabolic syndrome. Patients were divided into two groups depending on the presence or absence of microangiopathy.

Results: In the group with microangiopathy (n=36) in comparison with patients without complications (n=45) we found: larger waist circumference (88.9±11.7 vs. 83.7±10.2 cm; p=0.036), higher weight before diabetes (77.3±17.0 vs. 67.0±12.5 kg; p=0.008), higher WHR (0.90±0.08 vs. 0.86±0.08; p=0.048), higher level of triglycerides (1.3±0.8 vs. 0.9±0.3 mmol/l; p=0.002) and lower eGDR (7.2±2.4 vs. 8.8±1.9 mg/kg/min; p=0.0019). In patients with microangiopathy, features of metabolic syndrome were found more often (12 (33.3%) vs. 4 (8.9%); p=0.006). A significant relationship, adjusted for sex, age and duration of diabetes, between eGDR and microangiopathy was revealed (OR 0.65 (95%CI 0.49–0.86); p=0.0037).

Conclusion: The results show that in patients with DM1, treated from the initial diagnosis with intensive insulin therapy, there is an independent relationship between IR and the diabetic microangiopathy.

Key words

diabetes mellitus type 1 - insulin resistance - risk factor - microangiopathy - glucose disposal rate

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Correspondence

Dr. A. Uruska

Department of Internal

Medicine and Diabetology

Poznan University of Medical

Sciences, Poland

Raszeja Hospital

Mickiewicza 2

60-834 Poznan

Poland

Phone: (0048) 61 8474579

Fax: (0048) 61 8474579

Email: aleksandrauruska@gmail.com