1.Insulin resistance and β-Cell function of lean versus overweight or obese Filipino patients with newly diagnosed Type 2 Diabetes Mellitus
Francesca Paula Bautista ; Gabriel Jasul Jr. ; Oliver Allan Dampil
Journal of the ASEAN Federation of Endocrine Societies 2019;34(2):164-170
		                        		
		                        			Objectives:
		                        			To compare the level of insulin resistance and β-cell function between lean and overweight/obese Filipino patients with newly diagnosed type 2 diabetes mellitus (T2DM).
		                        		
		                        			Methodology:
		                        			This was a cross-sectional analytical study including newly diagnosed T2DM Filipino patients from St. Luke’s Medical Center - Quezon City. The patients were classified as either lean or overweight/obese. Age, sex, smoking history, anthropometric measures and blood pressure were obtained. Insulin resistance and β-cell function were determined using the homeostasis model assessment (HOMA). The original model (HOMA1) and the updated model (HOMA2) were used. 
		                        		
		                        			Results:
		                        			A total of 80 subjects were included. There were 40 subjects in each group. The overweight/obese subjects had significantly higher mean insulin resistance (HOMA1-IR 9.8±11.7, HOMA2-IR 3.0±2.0) compared to the lean group (HOMA1-IR 2.9±1.5, HOMA2-IR 1.3±0.5). This was consistent in both HOMA1 and HOMA2 (p-values=0.001 and <0.001, respectively). The mean β-cell function of the overweight/obese patients was significantly higher than the  lean  subjects  when  using  HOMA1  (lean=57.8±35.5,  overweight/obese=93.6±66.4, p-value=0.003),  but  not  in HOMA2  (lean=57.6±30.5,  overweight/obese=74.8±45.7, p-value=0.051).  Overweight/obesity  increased  HOMA1-IR by 4.0 and HOMA1-B by 46.1 (p-values= 0.002 and <0.001, respectively). Through the use of HOMA2, overweight/obesity  increased  HOMA2-IR  by  1.4  and  HOMA2-B  by  29.1  (p-values<0.001).  Being  overweight/obese  was  also associated with significantly higher odds for developing greater insulin resistance (HOMA1-IR adjOR = 5.6, 95%CI= 1.7-19.2, p-value=0.005; HOMA2-IR adjOR=10.9, 95%CI=3.4-34.9, p-value<0.001) and lower odds for a decreased β-cell function (HOMA1-B adjOR = 0.2, 95%CI = 0.05-0.9, p-value=0.033; HOMA2-B adjOR=0.2, 95%CI=0.04-0.9, p-value=0.043) compared to being lean. 
		                        		
		                        			Conclusion
		                        			Newly diagnosed overweight/obese T2DM had higher mean insulin resistance and β-cell function compared to lean T2DM. Overweight/obesity was also associated with higher odds of developing insulin resistance and lower odds for a decreased β-cell function compared to being lean. The overweight/obese T2DM group also had worse metabolic profile manifested by higher FPG, HbA1c, SGPT and blood pressures compared to the lean T2DM group.
		                        		
		                        		
		                        		
		                        			Diabetes Mellitus, Type 2
		                        			;
		                        		
		                        			 Insulin Resistance
		                        			;
		                        		
		                        			 Overweight
		                        			
		                        		
		                        	
            

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