Insulin resistance, the metabolic syndrome, and complication risk in type 1 diabetes : Double diabetes in the diabetes control and complications trial

摘要: OBJECTIVE —The presence of insulin resistance and the metabolic syndrome are known risk markers for macrovascular disease in patients with without type 2 diabetes. This study has examined whether these also were predictors micro- complications 1 diabetic participating Diabetes Control Complications Trial (DCCT). RESEARCH DESIGN AND METHODS —International Federation (IDF) criteria used to identify 1,337 Caucasian DCCT at baseline. Insulin was calculated using their estimated glucose disposal rate (eGDR). dose (units/kg) as a separate marker resistance. RESULTS eGDR (but not or syndrome) baseline strongly predicted development retinopathy, nephropathy, cardiovascular (hazard ratios 0.75, 0.88, 0.70, respectively, per mg · kg−1 min−1 change; P < 0.001, = 0.005, 0.002, respectively). Through mainly weight gain, prevalence increased steadily from year 9 conventionally treated (from 15.5 27.2%) especially intensively 13.7 45.4%) patients. CONCLUSIONS —Higher (as by eGDR) associated subsequent both complications. IDF-defined poor comparison. Although intensive treatment higher syndrome, benefits improved glycemia appear outweigh risks related syndrome.