Endocrine Abstracts

Objective: The aim of the study was to determine frequency of insulin resistance, in individuals with type 1 diabetes mellitus and the link between insulin resistance and cardiovascular disease, sex hormones. The task of the research is to determine the frequency of insulin resistance among people with diabetes mellitus type 1. To determine association between eGDR and age, sex, cardiovascular disease, chronic complications of diabetes and sex hormones. To determine association between insulin resistance and duration of disease, body mass index, chronic complications of diabetes mellitus. To determine eGDR cutoff value when chronic complications of diabetes are more frequent. To find the association between insulin resistance and cardiovascular disease among people with diabetes mellitus type 1.

Research design and methods: The study is a part of an international research ‘Litdiane’. The study involved 200 people, with type 1 diabetes mellitus, over the age of 18 years. With reference to survey and information from medical records, performed the data analysis. Insulin resistance is associated with eGDR. It was calculated by the following formula eGDR=24.31- 2.22(LKS)-3.29 (AH)-0.57 (HbA1c%). Estimated glucose disposal rate was divided into tertiles. One – way ANOVA were used to contrast means between eGDR groups. To determine the influence of factors multinomial logistic regression method was applied. The data was considered statistically significant at P<0.05.

Results: Cutoff value of eGDR which shows resistance of insulin is <6.4 mg/kg/min. When eGDR is <6.4 mg/kg/min, diabetic complications were more common. eGDR is statistically significantly lower for patients with chronic complications of diabetes mellitus (P<0.001), and for patients with cardiovascular diseases (5.5±2.4 mg/kg/min (P<0.001)). eGDR has the highest influence on cardiovascular diseases occurrence (P=0.004). SHBG concentration is positively associated with higher eGDR. Testosterone levels are related with resistance of insulin in type 1 diabetes patients.

Conclusions: Diabetic complications are more common when eGDR is <6.4 mg/kg/min. Insulin resistance was found for 33.5% of patients. The resistance of insulin is statistically significantly associated with micro- and macro-vascular complications. Insulin resistance statistically significantly affects progression of cardiovascular disease. Smoking, male gender, low testosterone level, duration of disease were associated with resistance of insulin.