Racial and Ethnic Differences in an Estimated Measure of Insulin Resistance Among Individuals with Type 1 Diabetes

  1. Kirstie K. Danielson, Ph.D. (kdaniels{at}peds.bsd.uchicago.edu)1,
  2. Melinda L. Drum, Ph.D.2,
  3. Carmela L. Estrada, M.P.H.1 and
  4. Rebecca B. Lipton, Ph.D.1,2
  1. 1Institute for Endocrine Discovery and Clinical Care, University of Chicago
  2. 2Department of Health Studies, University of Chicago

Abstract

Objective: Insulin resistance (IR) is greater in racial/ethnic minorities than in non-Hispanic whites (NHW) for those with and without type 2 diabetes. Because previous research on IR in type 1 diabetes was limited to NHW, racial/ethnic variation in an estimated measure of IR in type 1 diabetes was determined.

Research Design and Methods: The sample includes 79 type 1 diabetes individuals diagnosed <18 years old [NHW=32.9%, non-Hispanic black (NHB)=46.8%, Other/Mixed=7.6%, Hispanic=12.7%] and their families. Estimated glucose disposal rate [eGDR (mg kg−1 min−1); lower eGDR=greater IR] was calculated using HbA1c, waist circumference, and hypertension status.

Results: Mean current age and diabetes duration were 13.5 (range: 3.2-32.5) and 5.7 (0.1-19.9) years, respectively. eGDR was inversely associated with age. Compared to NHW, age-adjusted eGDR was significantly lower among non-whites (NHB, Other/Mixed, and Hispanic; □□−1.83, P=0.0006). Age-adjusted eGDR was negatively associated with bodyfat, triglycerides, urinary albumin/creatinine, acanthosis nigricans, parental obesity, and parental IR, and positively related to HDL and sex hormone-binding globulin. In multivariable analysis, lower eGDR was significantly associated with older age, non-white race/ethnicity, acanthosis, and lower HDL.

Conclusions: Minorities with type 1 diabetes are significantly more IR, as measured by eGDR, than NHW. Exploring potential mechanisms, including disparities in care and/or physiological variation, may contribute to preventing racial/ethnic differences in IR-associated outcomes.

Footnotes

    • Received November 5, 2009.
    • Accepted November 25, 2009.

This Article

  1. Diabetes Care
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