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Author: Jenkins, Alicia × End date: 2024 ×

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    Validation of Formulae to Estimate Insulin Sensitivity in Type 1 Diabetes
    Januszewski, AS ; Niedzwiecki, P ; Sachithanandan, N ; Ward, GM ; Karschimkus, C ; O'Neal, DN ; Zozulinska-Ziolkiewicz, D ; Uruska, A ; Jenkins, A (AMER DIABETES ASSOC, 2021-06)
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    Estimation of glucose disposal rate in type 1 diabetes using clinical and research biomarkers
    Jenkins, AJ ; Januszewski, AS ; Sachithanandan, N ; Ward, G ; Karschimkus, C ; O'Neal, DN (SPRINGER, 2018-10)
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    Estimated insulin sensitivity in Type 1 diabetes adults using clinical and research biomarkers
    Januszewski, AS ; Sachithanandan, N ; Ward, G ; Karschimkus, CS ; O'Neal, DN ; Jenkins, AJ (ELSEVIER IRELAND LTD, 2020-09)
    AIMS: Insulin resistance in people with type 1 diabetes (T1D) is associated with increased risk of chronic complications and death. The gold standard to quantify insulin sensitivity, a euglycaemic hyperinsulinaemic clamp, is not applicable to clinical practice. We have employed clamp studies to develop a panel of formulae to estimate insulin sensitivity in adults with T1D for use in clinical practice and trials. METHODS: Clamps were conducted in 28 adults with T1D, who were also characterised with 38 clinical and research biomarkers. Exhaustive search analysis was used to derive equations correlating with clamp-quantified glucose disposal rate (GDR), GDR/plasma insulin (M/I) and log10M/I. RESULTS: Measured insulin sensitivity correlated with BMI, WHR, HDL-C, adipokines and inflammation markers on univariate analysis. Exhaustive search analysis derived three formulae correlating with clamp-derived GDR and logM/I (p < 0.0001), accounting for ≈62% of their variability. A formula using gender, age, HDL-C, pulse pressure and WHR performed as well as those containing inflammation and adipokine measures. CONCLUSIONS: The performance of formulae using routinely available parameters with/without research biomarkers in clinical studies and trials, particularly related to future complications, relevant lifestyle interventions, insulin delivery modes and insulin sensitisers is merited.
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    Independent euglycaemic hyperinsulinaemic clamp studies validate clinically applicable formulae to estimate insulin sensitivity in people with type 1 diabetes
    Januszewski, AS ; Niedzwiecki, P ; Sachithanandan, N ; Ward, GM ; Karschimkus, CS ; O'Neal, DN ; Zozulinska-Ziolkiewicz, DA ; Uruska, AA ; Jenkins, AJ (ELSEVIER SCI LTD, 2023-01)
    BACKGROUND AND AIM: Low insulin sensitivity (IS) increases Type 1 diabetes (T1D) complication risk and can be estimated by simple formulae developed from complex euglycemic hyperinsulinaemic clamp studies. We aimed to validate these formulae using independent clamp data. METHODS: Clamps were performed in 104 T1D adults. Measured glucose disposal rate (GDR) was correlated with eGDR and eLog10 M/I calculated by five IS formulae. RESULTS: Correlations ranged between 0.23-0.40. Two IS formulae (by the authors), using age, sex, HDL-C, HbA1c, pulse pressure, BMI, and waist-hip-ratio had the highest correlation with measured GDR and the best performance in detecting low IS.
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    Independent euglycaemic hyperinsulinaemic clamp studies validate clinically applicable formulae to estimate insulin sensitivity in people with type 1 diabetes (vol 17, 102691, 2023)
    Januszewski, AS ; Niedzwiecki, P ; Sachithanandan, N ; Ward, GM ; Karschimkus, CS ; O'Neal, DN ; Zozulinska-Ziolkiewicz, DA ; Uruska, AA ; Jenkins, AJ (ELSEVIER SCI LTD, 2023-01)
    The authors regret that in the original article, on the second page, in the section with eGDR equations, variables “sex” and “hypertension” were missing categorical values indicators (“F = 0, M = 1”; “Yes = 1, No = 0”, respectively) required to calculate eGDR. It should be corrected by adding “F = 0, M = 1” in two instances and “Yes = 1, No = 0” in one instance. Also, please note that Miller at al. defined “hypertension” as BP ≥140/90mmHg or use of any anti-hypertensive (drug) treatment. The authors apologise for any inconvenience caused.
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    Interactive Calculator to Estimate Insulin Sensitivity (IS) in Type 1 Diabetes
    Januszewski, AS ; Niedzwiecki, P ; Sachithanandan, N ; Ward, GM ; O'Neal, DN ; Zozulinska-Ziolkiewicz, D ; Uruska, A ; Jenkins, A (AMER DIABETES ASSOC, 2023-06)
    Introduction: Euglycemic hyperinsulinemic clamps, although costly, time- and labor-intensive, are “gold standard” in measuring insulin sensitivity (IS). Several formulae to estimate IS in people with Type 1 diabetes (T1D) exist (DOI: 10.1007/978-3-030-81303-1_18-1), using various routine and research assays, and with wide ranging IS results. Aim: To develop a free online tool to estimate IS using different metrics and existent formulae and compare estimated IS with measured glucose disposal rate (GDR) from 104 clamp studies. Methods: We prepared an online tool for calculating IS using 17 formulae. Suitable formula(e) are suggested based on available (clinical and research) data. We also compare calculated IS with measured IS (GDR) from clamp studies in 104 adults with T1D (mean±SD) age 34±7 yrs, T1D duration 10±4 yrs, HbA1c 7.7±1.5%, 33 with microvascular complications). Logistic regression was used to infer probability of calculated IS being below GDR=4.45 mg/kg/min or above GDR=6.5 mg/kg/min, which represent respectively the median and 75th percentile of measured GDR values. Results: A calculator is available at www.bit.ly/estimated-GDR and an example result in the Figure 1. Estimated IS varied widely, but results interpretation is generally consistent. Conclusion: We developed an interactive tool to estimate IS in T1D for clinical and research use. Disclosure A.S.Januszewski: None. P.Niedzwiecki: None. N.Sachithanandan: None. G.M.Ward: None. D.N.O'neal: None. D.Zozulinska-ziolkiewicz: Advisory Panel; Abbott, Lilly, Lilly, Novo Nordisk, Medtronic, Speaker's Bureau; Abbott, Ascensia Diabetes Care, Novo Nordisk, Medtronic, Boehringer-Ingelheim, AstraZeneca. A.Uruska: Other Relationship; Lilly, Boehringer-Ingelheim, AstraZeneca, Ascensia Diabetes Care, Sanofi. A.Jenkins: Advisory Panel; Insulet Corporation, Board Member; Insulin for Life, Research Support; Abbott Diabetes, Medtronic, Hemsley Charitable Trust, Juvenile Diabetes Research Foundation (JDRF), National Institutes of Health.