THE ASSOCIATION BETWEEN INSULIN RESISTANCE AND ADVANCED RENAL DISEASE IN TYPE 1 DIABETES
Background and Aims. Insulin resistance is documented in type 1 diabetes and it has been associated with chronic complications. Diabetic nephropathy is a major cause of morbidity and mortality. The purpose of this article is to quantify insulin resistance in type 1 diabetes subjects according to the presence or absence of advanced renal disease. A secondary objective was to study the possible association between insulin resistance and advanced renal disease. Material and Methods. This was a cross-sectional study that included 167 type 1 diabetes patients. Insulin resistance was determined using the eGDR (estimated glucose disposal rate) formula. The association between eGDR and diabetic nephropathy was assessed in uni and multivariate models using stepwise logistic regression analysis of variables. The contribution of individual predictors in the final regression model was examined using Wald statistic. Results. Significantly lower eGDR’s values were observed in patients with nephropathy: 5 vs. 7.3 (p<0.001). In univariate analysis eGDR was significantly associated with diabetic nephropathy (p<0.001). eGDR variable was retained in the final model of stepwise logistic regression (p<0.001) and showed the strongest association with diabetic nephropathy (Wald = 30.4). Conclusions. In type 1 diabetes patients insulin resistance was the most important independent risk factor associated with advanced renal disease.