Is ER a better indicator to assess diabetes mellitus: A study among diabetics and non diabetics

Abstract

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Insulin resistance (IR) is the main cause of type 2 diabetes mellitus and one of the most common underlying factors of metabolic syndrome. C-peptide is suggested as a better indicator of endogenous insulin secretion than insulin itself. The objective of this study was to determine the best parameter among fasting blood glucose (FBG), fasting serum insulin (FSI), fasting serum C-peptide (FSC), and IR to assess diabetes mellitus. The study was carried out in diabetic (n=30) and non-diabetic (n=30) adults aged 35-55 years. Subjects were enrolled from a clinic attached to University of Sri Jayewardenepura. Venous blood sample (1.5 mL) was obtained after 10 hours overnight fast and FBG, FSI and FSC levels were analyzed using standard kits. IR was calculated using following equation. HOMA-IR = FSI GiU/mL) x ' FBG (mmoL/L)/22.5. Results were analyzed using SPSS version 21. Diabetic subjects showed significantly higher mean FBG (145.47±71.29 mg/dL) (p=0.001), FSI (10.59±6.77pU/mL) (p=0.026), FSC (2.56±1.63 ng/mL) (p=0.001) and IR value (3.6±2.6) (p<0.001) compared to non- diabetic subjects (78.15±8.30 mg/dL, 5.82±2.65|iU/mL, 1.07±0.60 ng/mL and 1.12±0.53 respectively). So IR has showed the most significant difference between two groups. FBG had a weak correlation with FSI (r=0.277), a moderate correlation with FSC (r=0.403), and a strong correlation with IR (r=0.795). FSI showed strong correlations with FSC (r=0.665) and IR (r=0.727) whereas FSC had strong correlation with IR (r=0.665) at 0.01 significance level. Even though all assessed parameters were elevated in diabetic subjects, this study finding suggests that IR is a better indicator to assess diabetes mellitus than FBG, FSI and FSC.