# A pilot study on measured insulin sensitivity and estimated glucose disposal rates in adults with type 1 diabetes and diabetic kidney disease

## TL;DR

This pilot study explores insulin sensitivity in adults with type 1 diabetes and kidney disease, finding potential signs of increased insulin resistance.

## Contribution

The study is the first to use euglycemic-hyperinsulinemic clamps to assess insulin resistance in type 1 diabetes with diabetic kidney disease.

## Key findings

- M/I-values were 62.5% lower in individuals with type 1 diabetes and DKD, though not statistically significant.
- eGDR by Januszewski et al. showed the highest correlation with GDR in the DKD group.
- The study suggests increased insulin resistance in type 1 diabetes patients with diabetic kidney disease.

## Abstract

Diabetic kidney disease (DKD) in type 1 diabetes has been shown to be strongly associated with insulin resistance, but this has not been previously explored using the euglycemic-hyperinsulinemic clamp. Therefore, we investigated insulin sensitivity in people with type 1 diabetes with and without DKD using M/I-values (mean glucose disposal rates [GDR]/mean plasma insulin) and compared GDRs to estimated GDR (eGDR)-formulae.

In this pilot study, we studied 17 adult individuals with type 1 diabetes (ten with and seven without DKD) using euglycemic-hyperinsulinemic clamps and assessed correlations between GDR and eGDR values.

M/I-values were 62.5% lower in individuals with type 1 diabetes and DKD compared to those without DKD, albeit not statistically significant (0.16 ± 0.08 vs. 0.10 ± 0.08 mg/kg/min per mIU/L, P = 0.154). In the whole group (n = 17) eGDR by Williams et al. demonstrated the highest correlation with GDR (r = 0.35, P = 0.167), while eGDR by Januszewski et al. had the highest correlation in the DKD group (n = 10, r = 0.46, P = 0.177).

Our pilot study suggests the possibility of increased insulin resistance in people with type 1 diabetes and DKD.