Study of Insulin Resistance by Homeostatic Model Assessment (Homa) in Type 2 Diabetes Mellitus Patients and Its Correlation with Diabetic Nephropathy
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 2
Abstract
Abstract: Many studies showed that Insulin resistance is present in chronic renal failure and evidences suggest that Insulin resistance can also occur in early stages of renal disease. In Indian Scenario there is paucity of data available, so this study was conducted to establish relationship between Insulin Resistance with various stages of Diabetic nephropathy, if any. Study subjects and methods: This is cross sectional study where total 100 subjects are included and are divided into three groups according to their renal status, Group 1 (control) n=19, group 2 (Normoalbuminuria) n=21, group 3 (Microalbuminuria) n=39 and group 4 (Macroalbuminuria) n=21. Seem Insulin measurement was estimated by chemiluminescence method. Insulin resistance was calculated using Homeostatic Model Assessment (HOMA method). The normal cut off value for HOMA IR (2.4) was derived using mean+2SD of control group. Subjects on Insulin therapy was kept in exclusion crieteria. Results: Mean HOMA IR increased significantly with decreasing renal function. Larger percentage of subjects had HOMA IR (≥2.4) at different stages of diabetic kidney disease (Normo albuminuria: 60%; Microalbuminuria: 76%, Microalbuminuria: 92%) compared to normal (32%). There was no significant difference between the study groups with respect to age, BMI, duration of diabetes, duration of nephropathy, habits, glycemic control. The results of multiple logistic regression analysis showed an association between HOMA IR and diabetic nephropathy. Conclusion: There is an association between Insulin Resistance and diabetic kidney disease in type 2 diabetes. In day to day practice clinicians must think about insulin resistance in diabetic patients. It should be measured in all the diabetic patients because it is cheap and easily measurable from FPI and fasting blood sugar level. Its measurement will help to prevent the development of various complications of diabetes at early stages.
Authors and Affiliations
Dr. Sushama Jotkar, Dr. Sangram Deshmukh
Keywords
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