| ORIGINAL ARTICLE |
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| Year : 2022 | Volume
: 1
| Issue : 1 | Page : 3-8 |
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Insulin resistance in early and advanced diabetic kidney disease
Vedavati B Purandare1, Arjun L Kakrani2, Charan B Bale3, Shalbha Tiwari4, Ambika G Unnikrishnan1
1 Department of Diabetes and Endocrinology, Chellaram Diabetes Institute, Pune, Maharashtra, India
2 Department of Medicine, Dr. D. Y Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
3 Department of Diabetes and Endocrinology, Chellaram Diabetes Institute; Department of Nephrology, Dr. D. Y Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
4 Department of Research, Chellaram Diabetes Institute, Pune, Maharashtra, India
Correspondence Address:
Ambika G Unnikrishnan
Chellaram Diabetes Institute, Pune, Maharashtra
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/cdrp.cdrp_7_21
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Background: Insulin resistance (IR) is commonly seen in diabetic kidney disease (DKD) and could contribute to the progression of renal disease and cardiovascular risk. In this study, we aim to measure homeostasis model assessment IR (HOMA-IR) in DKD and see the effect of advancing kidney disease on HOMA IR. Material and Methods: We recruited 120 subjects with type 2 diabetes mellitus and divided them into people without kidney disease (controls; n = 20), early DKD (n = 40), and advanced DKD (n = 60). Biochemical tests including fasting plasma glucose and fasting serum C-peptide were done in 120 subjects. IR was calculated by the HOMA model in 109 subjects. Data were presented as median (interquartile range [IQR]). Univariable and multivariable analysis was done. Results: Median of HOMA-IR in the control group was 2.0 (IQR: 1.5–2.8; n = 20), early DKD group was 2.3 (1.8–2.9; n = 37), and advanced DKD group was 3.67 (1.6–3.9; n = 52). P = 0.03 indicated a significant increase in the HOMA IR with advancing kidney disease. Conclusion: In patients with DKD, with advancing kidney disease, there was a significant increase in the HOMA IR, a marker of IR. IR is a modifiable metabolic risk factor, and if it is managed by novel therapeutic ways, it might improve clinical outcomes in DKD.
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