The following is a summary of “Development of a New Model of Insulin Sensitivity in Patients With Type 2 Diabetes and Association With Mortality,” published in the May 2024 issue of Endocrinology by Ciardullo, et al.

For a study, researchers sought to develop an insulin sensitivity (IS) model using readily available clinical and laboratory parameters in patients with type 2 diabetes (T2D) and assess its association with all-cause and cardiovascular mortality.

A total of 140 patients with T2D underwent an euglycemic hyperinsulinemic clamp to measure the total body glucose disposal rate (mg kg^-1 minute^-1). Insulin sensitivity was estimated using demographic, clinical, and laboratory parameters via stepwise linear regression in a training cohort of 85 patients and validated in a validation cohort of 55 patients. The developed model was applied to 3,553 patients with T2D  from the National Health and Nutrition Examination Survey (NHANES) to evaluate its association with mortality.

The optimal model included triglycerides, gamma-glutamyl transpeptidase, albumin excretion rate, and body mass index. The estimated IS score correlated well with clamp-derived glucose disposal rate in both the training (r = 0.77, P < .001) and validation (r = 0.74, P < .001) cohorts. In the NHANES cohort, after a median follow-up of 8.3 years, 1,054 patients died, 265 of cardiovascular causes. A higher estimated IS was associated with a lower risk of all-cause and cardiovascular mortality after adjusting for various factors.

The study proposed a novel IS model for patients with T2D using common clinical and laboratory parameters. The model showed promising associations with mortality risks, which could have implications for diagnosis and prognostication in clinical practice.

Reference: academic.oup.com/jcem/article-abstract/109/5/1308/7441963