USA: A recent study published in the journal Diabetes Research and Clinical Practice has highlighted the importance of insulin resistance (IR) changes in the development of diabetes complications. This implies the need for intensive therapy in patients with type 1 diabetes (T1D) and IR.
Till now, no longitudinal study has evaluated the changes in IR status and development of complications in type 1 diabetes. Yuanjie Mao and Wenjun Zhong from the USA aimed to investigate the associations of IR status changes and diabetic complications in T1D by analyzing data sets from DCCT/EDIC study.

For this purpose, they calculated the estimated glucose disposal rate (eGDR) at the entry of DCCT and in EDIC year 12 (average 18.5 years later) to represent IR. 957 participants were divided into four groups based on IR changes from baseline: RR group (stayed resistant; n = 49), RS group (became sensitive; n = 42), SR group (became resistant; n = 197), and SS group (stayed sensitive; n = 669). Multivariable logistic regression models was used to analyze the association of diabetic complications.
The study revealed the following findings:
· The improved IR decreased the risk of peripheral neuropathy, whereas the deteriorated IR increased the risk of diabetic complications including hypertension, peripheral artery disease, coronary artery calcification, retinopathy, albuminuria, peripheral neuropathy, and cardiac autonomic neuropathy.
· RR group (HR = 3.59), RS group (HR = 2.27), and SR group (HR = 1.90) had a higher risk of cardiovascular events compared to SS group.
"These findings highlight the importance of IR changes represented by eGDR in the development of diabetic complications," wrote the authors. "This underscores the need for intensive therapy in patients with T1D and IR."
Reference:
The study titled, "Changes of insulin resistance status and development of complications in type 1 diabetes mellitus: Analysis of DCCT/EDIC study," was published in the journal Diabetes Research and Clinical Practice.
DOI: https://doi.org/10.1016/j.diabres.2022.109211