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Purpose <p>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.</p> Methods <p>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.</p> Results <p>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&#xa0;mg/kg/min per mIU/L, <i>P</i> = 0.154). In the whole group (<i>n</i> = 17) eGDR by Williams et al. demonstrated the highest correlation with GDR (<i>r</i> = 0.35, <i>P</i> = 0.167), while eGDR by Januszewski et al. had the highest correlation in the DKD group (<i>n</i> = 10, <i>r</i> = 0.46, <i>P</i> = 0.177).</p> Conclusion <p>Our pilot study suggests the possibility of increased insulin resistance in people with type 1 diabetes and DKD.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月3日

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  • Johan R Simonsen,
  • Daniel Gordin,
  • Andrzej S Januszewski,
  • Alicia J Jenkins,
  • Daniël H van Raalte,
  • Michael JB van Baar,
  • Petter Bjornstad,
  • Lena M Thorn,
  • Per-Henrik Groop

摘要

Purpose

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.

Methods

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.

Results

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).

Conclusion

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