Insulin resistance and associated factors in patients with Type 1 Diabetes.
OBJECTIVE
To assess the presence of insulin resistance (IR) in patients with type 1 diabetes (T1DM) according to the estimated glucose disposal rate formula (eGDR) and the insulin sensitivity score (ISS) and to estimate the correlation between these two measures and identify the clinical and laboratory markers related to IR.


METHODS
Cross-sectional study of adults with T1DM (n = 135). The results of the formulas that estimate IR were separated into quartiles and correlated with demographic data, clinical characteristics and laboratory parameters. We analyzed the total and regional adiposity by dual-energy X-ray absorptiometry and skin fold thickness measurements.


RESULTS
Two thirds of the patients were overweight or obese. A moderate correlation was found between eGDR and ISS (r = 0.612). The results of both formulas were positively correlated with BMI (r = -0.373 eGDR and r = -0.721 ISS), thoracic-abdominal fat (r = -0.484 eGDR and r = -0.758 ISS), waist/height ratio (r = -0.537 eGDR and r = -0.779 ISS), subscapular skinfold (mm) (r = -0.356 eGDR and r = -0.569 ISS), total dose insulin IU/lean mass (kg) (r = -0.279 eGDR and r = -0.398 ISS), age (years) (r = -0.495 eGDR and r = -0.190 ISS) and diabetes duration (years) (r = -0.428 eGDR and r = -0.187 ISS). A moderate agreement (Kappa 0.226) was observed between the 1st quartile of results determined by the formulas in 10.4% of the patients, but the 4th quartile presented a strong correlation (Kappa 0.679). The individuals with IR that were classified in the 1st quartile by the ISS formula had a higher chance of presenting with acanthosis nigricans (OR = 5.58, 95% CI =1.46-21.3).


CONCLUSIONS
The correlations found in this study indicate the possibility of using clinical and laboratory data to estimate IR in patients with TDM1. The detection of IR in T1DM patients may allow early intervention and possibly impact on future diabetes complications.
Federal University of Minas Gerais UFMG, Rua Padre Rolim 769, sala 802. Bairro São Lucas, Belo Horizonte, Minas Gerais Brazil.
Mônica Maria
MM
Teixeira
Department of Internal Medicine, UFMG, Belo Horizonte, Minas Gerais Brazil.
Maria de Fátima Haueisen Sander
Mde F
Diniz
Endocrinology Service, Santa Casa of Belo Horizonte, Belo Horizonte, Minas Gerais Brazil.
Janice Sepúlveda
JS
Reis
Department of Internal Medicine, UFMG, Belo Horizonte, Minas Gerais Brazil.
Teresa Cristina Abreu
TC
Ferrari
Centre for Studies in Densitometry, Belo Horizonte, Minas Gerais Brazil.
Maria Goretti Bravim
MG
de Castro
Federal University of Minas Gerais UFMG, Rua Padre Rolim 769, sala 802. Bairro São Lucas, Belo Horizonte, Minas Gerais Brazil.
Bruna Polonio
BP
Teixeira
Federal University of Minas Gerais UFMG, Rua Padre Rolim 769, sala 802. Bairro São Lucas, Belo Horizonte, Minas Gerais Brazil.
Isabella Cristina da Silva
IC
Arantes
Federal University of Minas Gerais UFMG, Rua Padre Rolim 769, sala 802. Bairro São Lucas, Belo Horizonte, Minas Gerais Brazil.
Danielle Marques
DM
Bicalho
Department of Internal Medicine, UFMG, Belo Horizonte, Minas Gerais Brazil.
Rodrigo Bastos
RB
Fóscolo
Estimated glucose disposal rate formula; Insulin resistance; Insulin sensitivity score; Type 1 diabetes