The Relationship between HbA1c, Insulin Resistance and Changes of Insulin Secretion in Indonesian Type 2 Diabetic Subjects

Srihardyastutie A.; Soeatmadji, D. W.; Fatchiyah; Aulanni'am
July 2014
Advances in Natural & Applied Sciences;Jul2014, Vol. 8 Issue 8, p25
Academic Journal
Type 2 Diabetes Mellitus (Type 2 DM) is considered as heterogenous metabolic disorder with the common characteristic of elevated blood glucose. The main cause of hyperglycemia in Type 2 DM are impaired of insulin secretion and increased insulin resistance. The HbA1c assay has become the most commonly used measure of chronic glycemia in epidemiological studies, clinical trials and the management of diabetes. However, the molecular patophysiology of HbA1c, insulin resistance and insulin secretion profile in development of type 2 diabetes still unclear. The study was carried out to evaluate the relationship of HbA1c and insulin resistance, and insulin secretion changes of type 2 DM patients. The study population consists of 67 peoples, which include: healthy control (n=21), prediabetes (n=10), and diabetes (n=36). The level of blood glucose, lipid profile (total cholesterol, triglyceride, HDL, and LDL) were determined fully automated analyzer using enzymatic methods. HbA1c was determined by ion-exchange high-performance liquid chromatography using an automated analyzer, insulin and pro-insulin were measured by Sandwich enzyme immunoassay methods. The insulin resistance was calculated using mathematical formula, such as HOMA-IR for β-cell function and QUICKI of insulin sensitivity. The results showed the fasting insulin level was significantly decreased in Type 2 DM, prediabetes and healthy control. Total insulin + pro-insulin in diabetes subject was significantly lower in diabetes than healthy control and prediabetes. Proinsulin level of healthy control was lower than prediabetes and diabetes, but proinsulin concentration in prediabetes and diabetes were not different. HbA1c and Insulin resistance (HOMA-IR) were significantly higher in Type 2DM than prediabetes and healthy control. Conclusion of this study were increasing blood glucose level in type 2 DM contributed to HbA1c, correlated with change of insulin secretion profile, by increasing proinsulin level and decreasing total insulin, and related with worsen insulin resistance.


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