Effect of increasing duration of diabetes mellitus type 2 on glycated hemoglobin and insulin sensitivity

Abstract

Non-insulin dependent diabetes mellitus (NIDDM) is the most rapidly growing chronic metabolic disorder in the world. With advancement in the age and duration of diabetes there is a gradual tendency for the level of blood sugar to rise along with a subsequent increase in the HbA1c as well as in the fasting insulin level. Whether this is an aging process or increased frequency of diabetes is still controversial. The correlation between glucose and insulin sensitivity is consistent with the idea that the degree of chronic hyperglycemia is a cause of excessive insulin resistance in type 2 diabetes, i.e. the insulin resistance which characterizes type 2 diabetes but not nondiabetic subjects matched for age, gender, family history and duration of diabetes. The study comprised a total of 76 subjects out of which 30 were normal, non-diabetic persons and the rest 46 were diabetics with different duration of time in years, after being diagnosed diabetic. Data was analyzed after dividing the subjects into four groups-Group 1 comprised of one year old diabetics, Group 2 was made up of those, who had diabetes, for the past 2-5 years, Group 3 included patients who were diabetic since more than 5 years and Group 4 included non-diabetics as the normal control group. The results obtained indicated that the HbA1c levels showed a significant increase with the duration of diabetes as well as the insulin level showed a significant correlation after adjustment for age, sex and duration of diabetes.

Glycemic Control and Its Determinants among Patients with type 2 Diabetes Mellitus Attending a Teaching Hospital

“…This finding is consistent with that reported in previous studies where longer duration of diagnosed diabetes was associated with increased HbA1c values [22][23][24]. This might be explained by that the amount of carbohydrate attached to the HbA1c increases with increasing duration of the disease [25].…”

Predictors of Good Glycemic Control Among Type Ii Diabetes Patients in Palestine

“…The finding of the univariate analysis of factors relating to good glycemic control is inconsistent with what is reported by other studies [39,40], but consistent with others [39,41] which noted that a progressive impairment of insulin secretion results from pancreatic β-cell failure, worsening type II diabetes over time, may lead to a negative impact on patient response to diet alone and/or oral hypoglycemic drugs and the need for a combination treatment of oral hypoglycemic drugs and insulin, higher doses, and/or additional medication which increases over time. However, an interrupted insulin supply in some cases and high insulin prices outside the governmental centers and the discomfort of insulin usage compared to oral hypoglycemic drugs could be a causal factor in poor glycemic control due to the insulin supply delay for more progressive type II diabetes patients.…”

Inadequate control of diabetes and metabolic indices among diabetic patients: A population based study from the Kerman Coronary Artery Disease Risk Study (KERCADRS)

“…Our results were consistent with the findings of these studies. It has been studied that advanced age and duration of diabetes have a significant association with increased likelihood of insulin resistance and levels of HbA1c (42). It is determined that aging and longer duration of diabetes are significant predictors of uncontrolled HbA1c which may lead to chronic hyperglycemic and insulin insensitivity (43).…”