Racial and ethnic differences in an estimated measure of insulin resistance among individuals with type 1 diabetes.

Abstract

OBJECTIVE Insulin resistance is greater in racial/ethnic minorities than in non-Hispanic whites (NHWs) for those with and without type 2 diabetes. Because previous research on insulin resistance in type 1 diabetes was limited to NHWs, racial/ethnic variation in an estimated measure of insulin resistance in type 1 diabetes was determined. RESEARCH DESIGN AND METHODS The sample included 79 individuals with type 1 diabetes diagnosed at age <18 years (32.9% NHWs, 46.8% non-Hispanic black [NHB], 7.6% other/mixed, and 12.7% Hispanic) and their families. Estimated glucose disposal rate (eGDR) (milligrams per kilogram per minute; a lower eGDR indicates greater insulin resistance) was calculated using A1C, waist circumference, and hypertension status. RESULTS Mean current age was 13.5 years (range 3.2-32.5) and diabetes duration was 5.7 years (0.1-19.9). eGDR was inversely associated with age. Compared with that in NHWs, age-adjusted eGDR was significantly lower among nonwhites (NHB, other/mixed, and Hispanic: Delta = -1.83, P = 0.0006). Age-adjusted eGDR was negatively associated with body fat, triglycerides, urinary albumin/creatinine, acanthosis nigricans, parental obesity, and parental insulin resistance and positively related to HDL and sex hormone-binding globulin. In multivariable analysis, lower eGDR was significantly associated with older age, nonwhite race/ethnicity, acanthosis, and lower HDL. CONCLUSIONS Minorities with type 1 diabetes are significantly more insulin resistant, as measured by eGDR, than NHWs. Exploring potential mechanisms, including disparities in care and/or physiological variation, may contribute to preventing racial/ethnic differences in insulin resistance-associated outcomes.

• Authors: Kirstie K Danielson, Melinda L Drum, Carmela L Estrada, Rebecca B Lipton
• Journal: Diabetes care (Diabetes Care) Vol. 33 Issue 3 Pg. 614-9 (Mar 2010) ISSN: 1935-5548 [Electronic] United States
• PMID: 20007942 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Blood Glucose

Topics

• Adolescent
• Adult
• Blood Glucose (metabolism)
• Child
• Child, Preschool
• Diabetes Mellitus, Type 1 (diagnosis, epidemiology, ethnology, metabolism)
• Diagnostic Techniques, Endocrine (statistics & numerical data)
• Ethnicity (statistics & numerical data)
• Female
• Humans
• Insulin Resistance (ethnology)
• Male
• Racial Groups (statistics & numerical data)
• Young Adult