Comparison of different models of insulin resistance in T2DM: A cross-sectional study.


Comparison of different models of insulin resistance in T2DM: A cross-sectional study.

The prevalence of type 2 diabetes has been increasing rapidly resulting in increased morbidity and mortality. Studies suggest that intensification of glycemic control with insulin significantly decreased the risk of diabetic complications over a period of time. Early intensive insulin therapy in newly diagnosed type 2 diabetes mellitus patients might have better recovery and maintenance of β-cell function and longtime diabetic remission. Type 2 diabetes is progressive and that insulin will probably have to be used at some point. Introduction of short-acting insulin has apparently improved postprandial glucose control in type 2 diabetes mellitus.With the prevalence of type 2 diabetes on the rise and with the recognized need for strict glycemic control in the prevention of complications, strategies for aggressive treatment must be put into effect. Such strategies might include the early use of insulin, alone or in combination with other antidiabetic agents. Several studies have clearly shown that basal insulin therapy, particularly using the insulin analog glargine, closely mimics the body’s physiological secretion of basal insulin and may be added to an existing oral regimen, used alone, or used with preprandial insulin. Decision making regarding therapeutic approach and effectiveness of treatment depends on the measurement of insulin levels and sensitivity of tissues to insulin.

Insulin plays a major role in maintaining glucose homeostasis. Insulin resistance (IR) leads to impaired glucose tolerance and plays an important pathophysiological role in the development of diabetes. Insulin resistance (IR) is established by genetic and environmental factors. It is important to quantify IR as it is a predisposing factor for the development of metabolic syndrome, diabetes mellitus, cardiovascular diseases. Hyperinsulinemic-euglycemic clamp (HEC) is known to be the “gold standard” for the measurement of insulin sensitivity. However, the realization that it is time and money consuming led to the development of a simplified approach in the quantification of insulin sensitivity. Homeostasis model assessment (HOMA) and quantitative insulin sensitivity check index (QUICKI) are two clinically important insulin resistance/sensitivity indices..

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