INSULIN RESISTANCE, BETA CELL FUNCTION AND LIPID PROFILE IN METABOLIC SYNDROME AND TYPE 2 DIABETES MELLITUS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 87
Abstract
BACKGROUND Type 2 Diabetes mellitus is the commonest form of diabetes constituting 90% of the diabetic population. The global prevalence of diabetes is estimated to increase from 4% in 1995 to 5.4% by the year 2025. The highest prevalence of diabetes (16.6%) is seen in the city of Hyderabad in south India, as per the survey conducted by the ‘National Urban Diabetes Survey’ in 2001 by Ramachandran and Sneha Latha7 et al. The aim of our present study is to compare insulin resistance, beta cell function and the lipid profile of controls, individuals with metabolic syndrome and diabetic individuals in an urban setting like Hyderabad. MATERIALS AND METHODS This study is a descriptive comparative study. We enrolled 54 subjects in our study. Of the 54 subjects 15 are controls, 10 are insulin resistant/ individuals with metabolic syndrome and 29 are newly detected diabetic patients. Individuals with fasting plasma glucose < 110 mg/dL and without the minimum of three features of the metabolic syndrome set by the NCEP (Adult Treatment Panel- III)1 were selected as controls for the study. The insulin-resistant group was selected on the basis of the guideline set by the NCEP Adult Treatment Panel- III. Subjects with a minimum of three features were enrolled into the study as the insulin resistant group/ metabolic syndrome group. None of them had a fasting plasma glucose concentration of > 110 mg/dL. Hence, we referred to this group as the metabolic syndrome group/ insulin resistant euglycaemic group. Fasting plasma glucose of ≥ 126 mg/dL on 2 occasions was taken as the primary requisite for enrolling subjects into the diabetic group as per the guidelines of ADA. Fasting blood sample of 5 mL was collected by venepuncture into 3 different vacutainers (NaF, EDTA and plain). Fasting plasma glucose was estimated by GOD/POD (glucose oxidase-peroxidase) method. HbA1c is assayed for glycated haemoglobin by low-pressure cation-exchange chromatography in conjunction with gradient dilution. (Courtesy- Yashoda Hospitals, Malakpet). Fasting insulin, triglycerides and HDL-C were measured in the serum. Fasting insulin was assayed by ELISA method (BioTek instruments, Yashoda Hospitals, Malakpet). Triglycerides and HDL-C was assayed by Bayer’s kit on RA-50 semi auto analyzer. Reagents were purchased from Siemens and performed at Gandhi Hospital, Secunderabad. RESULTS Despite the small group of our present study, our findings correlated very well with the work done by previous researchers with regard to insulin resistance, pancreatic ß-cell function and lipid status in diabetes and the metabolic syndrome. HOMA-R was high in both ‘metabolic syndrome’ and ‘type 2 diabetes mellitus’ indicating insulin resistance in both the groups. Metabolic syndrome patients are able to maintain euglycaemia at the cost of hypersecretion by the pancreas. This is evident by the high HOMA-B in the metabolic syndrome group. Dyslipidaemia is a common feature found in metabolic syndrome and type 2 diabetes mellitus. CONCLUSION HOMA-R2 index is a simple, non-invasive useful marker for measuring ‘insulin resistance.’ Insulin sensitising drugs like Metformin can be used for metabolic syndrome individuals to prevent early onset of the disease and its sequel like retinopathy, nephropathy, neuropathy and cardiovascular disease. HOMA-B gives us an idea about the insulin produced by the beta cells of pancreas.
Authors and Affiliations
Vijaya Lakshmi Ayyala, Rama Krishna Malla, Ratna Kumari Gutta
Keywords
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- EP ID EP277699
- DOI 10.14260/jemds/2017/1311
- Views 86
- Downloads 0
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