Comparison of insulin sensitivity indices for detection of double diabetes in Indian adolescents with type 1 diabetes

Oza, Chirantap; Khadilkar, Anuradha; Karguppikar, Madhura; Gondhalekar, Ketan; Khadilkar, Vaman

doi:10.1515/jpem-2022-0076

Cited by 8 publications

(9 citation statements)

References 34 publications

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“…We thus concluded that Metformin may prevent deterioration in IS in Indian adolescents with T1D. 76 In T1DM, the favorable effects of Metformin are not only restricted to the reduction of insulin resistance but also to the reversal of micro and macrovascular complications when diagnosed sufficiently early. In a study by Pena et al on adolescents with T1DM, a significant association between early signs of atherosclerosis (as evidenced from cIMT) and retinal microvascular changes was observed irrespective of age, gender, HbA1c and blood pressure.…”

Section: Metformin Adjunct Therapymentioning

confidence: 79%

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Insulin Resistance in Adolescents and Youth With Type 1 Diabetes: A Review of Problems and Solutions

Khadilkar,

Oza,

Mondkar

2023

Clin Med Insights Endocrinol Diabetes

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Though insulin resistance (IR) was previously considered a feature of only type 2 Diabetes (T2DM), its development in type 1 Diabetes (T1DM) is not an uncommon occurrence, the causes of which are multifactorial (gender, pubertal status, diabetes duration, ethnicity, genetics, adiposity, glycemic control, chronic inflammation). Despite improvements in glucose, blood pressure and lipid profile, vascular complications (coronary artery disease and nephropathy) continue to remain common causes of morbidity and mortality in T1DM. Aggressive glycemic control reduces but does not eliminate the risk of IR. IR accelerates the development of micro and macrovascular complications, many of which can be potentially reversed if diagnosed and managed early. Lack of endogenous insulin production makes estimation of insulin sensitivity in T1DM difficult. As hyperinsulinemic-euglycemic clamp studies are cumbersome and invasive, the use of prediction equations for calculating estimated insulin sensitivity may prove to be useful. Along with intensive insulin therapy, dietary modifications and increasing physical activity, the role of Metformin in managing IR in T1DM is becoming increasingly popular. Metformin adjunct therapy in T1DM has been shown to improve insulin sensitivity, glycemic control, lipid profile, body composition, vascular smooth muscle function, thereby reducing the risk of vascular complications, as well as reversal of early vascular dysfunction. However, further studies to assess long-term efficacy and safety of Metformin use in adolescents and youth with T1DM are needed. This review aims at revisiting the pathophysiology of IR in T1DM and techniques of identifying those at risk so as to put into action various strategies for management of the same.

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Section: Metformin Adjunct Therapymentioning

confidence: 79%

“…8,[38][39][40] The author's group in a study on subjects from their center found that IS by SEARCH equation had highest accuracy in identifying IR and hence proposed its use in clinical practice in adolescents with T1DM at risk of developing metabolic as well as microvascular complications. 41…”

Section: Insulin Sensitivity Prediction Equationsmentioning

confidence: 99%

Insulin Resistance in Adolescents and Youth With Type 1 Diabetes: A Review of Problems and Solutions

Khadilkar,

Oza,

Mondkar

2023

Clin Med Insights Endocrinol Diabetes

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“…The increase in weight in T1DM could be explained by the intensive use and high doses of exogenous insulin therapy in the management of T1DM which in turn has an anabolic effect on lipid metabolism thus promoting lipogenesis and weight gain. Moreover, insulin resistance may develop in T1DM especially with onset of puberty and long duration of the disease with characteristic abdominal obesity and liability for development of metabolic syndrome (17,18) . As regards the clinical and laboratory findings, serum levels of cholesterol, triglyceride, LDL-C and CRP were significantly higher in patients group than controls.…”

Section: Discussionmentioning

confidence: 99%

Levels of Growth Differentiation Factor 15 and Interleukin-29 in Children and Adolescents with Type 1 Diabetes Mellitus

Afify¹,

Elzoghby²,

Sarhan³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Micro-vascular complications of type 1 diabetes are characterized by damage to the microvasculature of the kidney, retina, and neurons. Some proteins are interesting in their biological functions and can be engaged in the development of micro-angiopathy such as growth/differentiation factor 15 (GDF-15) and interleukin 29 . Aim: This study aimed to investigate the diagnostic value of growth/differentiation factor 15 (GDF-15) and interleukin 29 in cases of type one diabetes and its relation to micro-vascular complications. Subjects and Methods: This study included 80 participants that were divided into 3 groups. Group 1 included 20 patients with T1DM who had micro-vascular complications, group 2 contained 20 patients with T1DM who did not have microvascular complications and group 3: 40 healthy controls. All participants were subjected to full history taking and thorough clinical examination. Laboratory investigations included HbA1c, fasting lipid profile, micro-albumin in random urine sample, eGFR calculation, GDF-15 and IL-29 assay using ELISA kit. Results: There was a statistically significant difference between patients and control group as regards GDF-15 and IL29 (p= 0.041 and 0.013, respectively) which were higher in patients group. A high statistically significant difference was found between both groups as regards levels of GDF-15, which was higher in diabetic patients with complications than patients free of complications (p= 0.001). But no statistically significant difference between both patients' groups as regards levels of IL-29 (P > 0.05). Conclusion:Our results strongly indicate that in T1DM, serum GDF-15 level might serve as a useful marker to detect micro-angiopathy such as diabetic kidney disease, peripheral neuropathy, and retinopathy.

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“…The results of studies comparing indirect insulin resistance markers are incoherent and it is impossible to indicate at the moment which marker is better than others [ 71 , 81 , 122 ]. Moreover, the specific cut-points of different insulin resistance markers for IR and/or MS detection may vary depending on the ethnicity and the statistical methods used in studies.…”

Section: Recognition Of Double Diabetes—the Role Of Indirect Insulin ...mentioning

confidence: 99%

Double diabetes—when type 1 diabetes meets type 2 diabetes: definition, pathogenesis and recognition

Bielka,

Przezak,

Molęda

et al. 2024

Cardiovasc Diabetol

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Currently, the differentiation between type 1 diabetes (T1D) and type 2 diabetes (T2D) is not straightforward, and the features of both types of diabetes coexist in one subject. This situation triggered the need to discriminate so-called double diabetes (DD), hybrid diabetes or type 1.5 diabetes, which is generally described as the presence of the insulin resistance characteristic of metabolic syndrome in individuals diagnosed with T1D. DD not only raises the question of proper classification of diabetes but is also associated with a significantly greater risk of developing micro- and macroangiopathic complications, which was independent of glycaemic control. When considering the global obesity pandemic and increasing incidence of T1D, the prevalence of DD may also presumably increase. Therefore, it is of the highest priority to discover the mechanisms underlying the development of DD and to identify appropriate methods to prevent or treat DD. In this article, we describe how the definition of double diabetes has changed over the years and how it is currently defined. We discuss the accuracy of including metabolic syndrome in the DD definition. We also present possible hypotheses connecting insulin resistance with T1D and propose possible methods to identify individuals with double diabetes based on indirect insulin resistance markers, which are easily assessed in everyday clinical practice. Moreover, we discuss adjuvant therapy which may be considered in double diabetic patients.

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Comparison of insulin sensitivity indices for detection of double diabetes in Indian adolescents with type 1 diabetes

Cited by 8 publications

References 34 publications

Insulin Resistance in Adolescents and Youth With Type 1 Diabetes: A Review of Problems and Solutions

Insulin Resistance in Adolescents and Youth With Type 1 Diabetes: A Review of Problems and Solutions

Levels of Growth Differentiation Factor 15 and Interleukin-29 in Children and Adolescents with Type 1 Diabetes Mellitus

Double diabetes—when type 1 diabetes meets type 2 diabetes: definition, pathogenesis and recognition

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