To Study Insulin Resistance in Type 2 Diabetes Mallitus by Homa-IR Score

  • Dr Ashish Purohit Assistant professor, Department of Medicine, L N Medical college, Bhopal, India
  • Dr Varsha Tiwari Senior resident, Department of pediatrics, L N Medical college, Bhopal, India
Keywords: HOMA-IR, insulin resistance, type 2 diabetes, nephropathy, neuropathy

Abstract

Introduction: Insulin resistance precedes and strongly predicts the development of type 2 diabetes mellitus, estimation of insulin resistance was helpful in detection of early complications and selecting the treatment options, hence the present study was planned. HOMA estimated insulin resistance is an independent predictor of cardiovascular disease in type-2 diabetic subjects.

Materials and Methods: A case control study was carried out in the Department of Medicine comprising 50 newly diagnosed type 2 diabetes mellitus patients and 50 healthy controls. The HOMA IR method was used in the present study for estimation of insulin resistance as it is simple and appropriate.

Results: median value of fasting plasma insulin in cases was 7.45µU/ml with mean 10.53 ± 9.42µU/ml while in control was 7.19 with mean 7.43 ± 2.26µU/ml (p value 0.025856) and of fasting plasma glucose was 146 mg/dl with mean 164.12 + 54.43mg/dl and controls had median 112 with mean 110.6 + 7.07mg/dl (p value 0.000000). The median value of HOMA IR score is 2.91 in cases with mean value of 4.15 ± 3.56 and controls of 1.97, mean 2.03 + 0.64 (p value .000072). The most prevailing complications were retinopathy 26%(13,p<0.01) and neuropathy26%(13,P<0.01).

Conclusion: HOMA-IR score in present study was higher, it indicates that IR was higher in Patient of T2 DM in Gwalior Chambal zone as compared to other countries and high score is associated with increase risk of diabetic retinopathy, neuropathy, nepropathy, CAD, Peripheral vascular disease.

Downloads

Download data is not yet available.

References

1. World Health Organization. Definition, Diagnosis and classification of diabetes mellitus and its complications. Report of a WHO consultation,WHO;Geneva,1999. Available from Whqlibdoc.who.int/hq/1999/who_ncd_ncs_99.2.pdf cited on 4th Aug 2014.

2. National diabetes statistics report, 2014 – centers for disease control. http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf cited on 4th Aug 2014.

3. Diapedia, the living text book of diabetics. www.diapedia.org/type-1-diabetes-mellitus/environmental-factors Aug 13, 2014 cited on aug 2014.

4. Nolan JJ, Færch K. Estimating insulin sensitivity and beta cell function: perspectives from the modern pandemics of obesity and type 2 diabetes. Diabetologia. 2012 Nov; 55(11):2863-7. Epub 2012 Aug 22. [PubMed]

5. Martin BC1, Warram JH, Krolewski AS, Bergman RN, Soeldner JS, Kahn CR. Role of glucose and insulin resistance in the development of type 2 diabetes mellitus: results of a 25 year follow up study. Lancet. 1992 Oct 17;340(8825):925-9. [PubMed]

6. American Diabetes Association. Standards of Medical Care in Diabetes - 2008. Diabetes Care. 2008;31 (Suppl 1):S13-S54.

7. Bonora E, Saggaini F, Targher G, et al. Homeostasis Model Assessment closely mirrows the glucose clamp technique in the assessment of insulin sensitivity. Diabetes Care 2000;23:23-25.

8.Defronzo RA Tobin JD , Andres R . Glucose clamp technique: a method of quantifying insulin secretion and resistance.[internet] available from : Am J Physiol. 1979 Sep;237(3):E214-23. [PubMed]

9. Emoto M, Nishizawa Y, Maekawa K, Hiura Y, Kanda H, Kawagishi T, Shoji T, Okuno Y, Morii H: Homeostasis model assessment as a clinical index of insulin resistance in type 2 diabetic patients treated with sulfonylureas. Diabetes Care. 1999 May;22(5):818-22. [PubMed]

10. Fukushima M, Taniguchi A, Sakai M, Doi K, Nagasaka S, Tanaka H, Tokuyama K, Nakai Y: Homeostasis model assessment as a clinical index of insulin resistance: comparison with the minimal model analysis (Letter). Diabetes Care 22:1911, 1999.

11. Olefsky JM., Kollerman OG, Mechanisms of Insulin resistance in obesity and NIDDM.Amer. JJvted 1981,Am J Med Jan;70(1):151-68. [PubMed]

12. Matthews, DR, Hosker, JP; Rudenski, AS, Naylor, BA, Treacher, DF, Turner, RC. Homeostasis model assessment : insulin resistance and the cell function from fasting plasma glucose and insulin concentration in man. Diabetologia. 1985;28:412-419.

13. Nigerians. Adamu G Bakari and Geoffrey C Onyemelukwe: Insulin resistance in type 2 diabetic. Int J Diabetes & Metabolism (2005) 13: 24-27.

14. Vijay Viswanathan, priyanka TIlak, Rafi Meerza, Satyavani Kumpatla: Insulin resistance at different stages of diabetic kidney disease in India. Vol.58, Oct. 2010.

15. Akira Katsuki, MD, Yasuhiro Sumida, MD Rika Araki Sasaki, MD et al: Homeostasis Model Assessment is a reliable indicator of insulin resistance during follow up of patients with type 2 diabetes, Diabetes care 24:362-365, 2001.

16. Enzo Bonora, MD, PHd Stefan Kiechi, Johann Willett et al Insulin resistance as esimtaed by homesotasis model assessment predicts incident symptomatic cardiovascular disease in Caucasian subjects from the general population: Diabetes care: vol. 30, number 2 Feb. 2007.

17. Hui- Qi Qu, Quan Li et al . Definition of insulin Resistance using HOMA-IR for americans of Mexican descent using machine learning.june 14, 2011. Available from: http://www.plosone.org cited on 4th Aug 2014.
CITATION
DOI: 10.17511/ijmrr.2015.i1.02
Published: 2015-02-28
How to Cite
1.
Purohit A, Tiwari V. To Study Insulin Resistance in Type 2 Diabetes Mallitus by Homa-IR Score. Int J Med Res Rev [Internet]. 2015Feb.28 [cited 2024Nov.23];3(1):3-. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/176
Section
Original Article