Correlates of Insulin-Stimulated glucose Disposal in Recent Onset Type 1 and Type 2 Diabetes.

Context and Objective: Not only type 2, but also type 1 diabetes can associate with insulin resistance, as assessed from insulin-stimulated whole body glucose disposal (M-value). We hypothesized that different factors affect the M-value at the onset of type 1 and type 2 diabetes.

Design and Patients: We examined 132 patients with type 1 or type 2 diabetes matched for sex, age, and body mass index with known diabetes duration of less than 12 months. Multivariable linear regression analyses were applied to test the associations between glycemic control, blood lipids, adiponectin, pro-inflammatory immune mediators and M-value, obtained from from hyperinsulinemic-euglycemic clamps.

Results: Despite comparable age, BMI and near-normoglycemic control, mean M-value was lower in type 2 than in type 1 diabetes patients. Patients with type 1 diabetes had lower waist-to-hip ratio and serum triglycerides, but higher serum adiponectin than patients with type 2 diabetes, while circulating pro-inflammatory markers were not different. Even upon adjustments for glucose-lowering treatments, fasting blood glucose correlated negatively with M-value in both groups. But only in type 2 diabetes, gamma-glutamyl transferase - independent of any treatments - correlated negatively, whereas serum adiponectin correlated positively with M-values.

Conclusions: Fasting glycemia correlate with insulin-stimulated glucose disposal in both diabetes types, while altered liver and adipose tissue function associate with insulin-stimulated glucose disposal only in type 2 diabetes, underpinning specific differences between these diabetes types.