• Media type: E-Article
  • Title: Association of Baseline Characteristics With Insulin Sensitivity and β-Cell Function in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) Study Cohort
  • Contributor: Rasouli, Neda; Younes, Naji; Utzschneider, Kristina M.; Inzucchi, Silvio E.; Balasubramanyam, Ashok; Cherrington, Andrea L.; Ismail-Beigi, Faramarz; Cohen, Robert M.; Olson, Darin E.; DeFronzo, Ralph A.; Herman, William H.; Lachin, John M.; Kahn, Steven E.; Crandall, Jill P.; McKee, Melissa Diane; Brown-Friday, Janet; Xhori, Entila; Ballentine-Cargill, Keisha; Duran, Sally; Lukin, Jennifer; Beringher, Stephanie; de la torre, Susana Gonzalez; Phillips, Lawrence; Burgess, Elizabeth; [...]
  • Published: American Diabetes Association, 2021
  • Published in: Diabetes Care
  • Extent: 340-349
  • Language: English
  • DOI: 10.2337/dc20-1787
  • ISSN: 0149-5992; 1935-5548
  • Keywords: Advanced and Specialized Nursing ; Endocrinology, Diabetes and Metabolism ; Internal Medicine
  • Abstract: <jats:sec> <jats:title>OBJECTIVE</jats:title> <jats:p>We investigated sex and racial differences in insulin sensitivity, β-cell function, and glycated hemoglobin (HbA1c) and the associations with selected phenotypic characteristics.</jats:p> </jats:sec> <jats:sec> <jats:title>RESEARCH DESIGN AND METHODS</jats:title> <jats:p>This is a cross-sectional analysis of baseline data from 3,108 GRADE (Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study) participants. All had type 2 diabetes diagnosed &amp;lt;10 years earlier and were on metformin monotherapy. Insulin sensitivity and β-cell function were evaluated using the HOMA of insulin sensitivity and estimates from oral glucose tolerance tests, including the Matsuda Index, insulinogenic index, C-peptide index, and oral disposition index (DI).</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>The cohort was 56.6 ± 10 years of age (mean ± SD), 63.8% male, with BMI 34.2 ± 6.7 kg/m2, HbA1c 7.5 ± 0.5%, and type 2 diabetes duration 4.0 ± 2.8 years. Women had higher DI than men but similar insulin sensitivity. DI was the highest in Black/African Americans, followed by American Indians/Alaska Natives, Asians, and Whites in descending order. Compared with Whites, American Indians/Alaska Natives had significantly higher HbA1c, but Black/African Americans and Asians had lower HbA1c. However, when adjusted for glucose levels, Black/African Americans had higher HbA1c than Whites. Insulin sensitivity correlated inversely with BMI, waist-to-hip ratio, triglyceride-to-HDL-cholesterol ratio (TG/HDL-C), and the presence of metabolic syndrome, whereas DI was associated directly with age and inversely with BMI, HbA1c, and TG/HDL-C.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>In the GRADE cohort, β-cell function differed by sex and race and was associated with the concurrent level of HbA1c. HbA1c also differed among the races, but not by sex. Age, BMI, and TG/HDL-C were associated with multiple measures of β-cell function and insulin sensitivity.</jats:p> </jats:sec>
  • Description: <jats:sec>
    <jats:title>OBJECTIVE</jats:title>
    <jats:p>We investigated sex and racial differences in insulin sensitivity, β-cell function, and glycated hemoglobin (HbA1c) and the associations with selected phenotypic characteristics.</jats:p>
    </jats:sec>
    <jats:sec>
    <jats:title>RESEARCH DESIGN AND METHODS</jats:title>
    <jats:p>This is a cross-sectional analysis of baseline data from 3,108 GRADE (Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study) participants. All had type 2 diabetes diagnosed &amp;lt;10 years earlier and were on metformin monotherapy. Insulin sensitivity and β-cell function were evaluated using the HOMA of insulin sensitivity and estimates from oral glucose tolerance tests, including the Matsuda Index, insulinogenic index, C-peptide index, and oral disposition index (DI).</jats:p>
    </jats:sec>
    <jats:sec>
    <jats:title>RESULTS</jats:title>
    <jats:p>The cohort was 56.6 ± 10 years of age (mean ± SD), 63.8% male, with BMI 34.2 ± 6.7 kg/m2, HbA1c 7.5 ± 0.5%, and type 2 diabetes duration 4.0 ± 2.8 years. Women had higher DI than men but similar insulin sensitivity. DI was the highest in Black/African Americans, followed by American Indians/Alaska Natives, Asians, and Whites in descending order. Compared with Whites, American Indians/Alaska Natives had significantly higher HbA1c, but Black/African Americans and Asians had lower HbA1c. However, when adjusted for glucose levels, Black/African Americans had higher HbA1c than Whites. Insulin sensitivity correlated inversely with BMI, waist-to-hip ratio, triglyceride-to-HDL-cholesterol ratio (TG/HDL-C), and the presence of metabolic syndrome, whereas DI was associated directly with age and inversely with BMI, HbA1c, and TG/HDL-C.</jats:p>
    </jats:sec>
    <jats:sec>
    <jats:title>CONCLUSIONS</jats:title>
    <jats:p>In the GRADE cohort, β-cell function differed by sex and race and was associated with the concurrent level of HbA1c. HbA1c also differed among the races, but not by sex. Age, BMI, and TG/HDL-C were associated with multiple measures of β-cell function and insulin sensitivity.</jats:p>
    </jats:sec>
  • Footnote:
  • Access State: Open Access