The relation between parameters from homeostasis model assessment and glycemic control in type 2 diabetes.

Dansuntornwong, Bantita; Chanprasertyothin, Suwannee; Jongjaroenprasert, Wallaya; Ngarmukos, Chardpraon; Bunnag, Pongamorn; Puavilai, Gobchai; Ongphiphadhanakul, Boonsong

The relation between parameters from homeostasis model assessment and glycemic control in type 2 diabetes.

Date

2007-11-10

Authors

Dansuntornwong, Bantita

Chanprasertyothin, Suwannee

Jongjaroenprasert, Wallaya

Ngarmukos, Chardpraon

Bunnag, Pongamorn

Puavilai, Gobchai

Ongphiphadhanakul, Boonsong

Abstract

OBJECTIVE: To determine the association of insulin sensitivity and pancreatic beta-cell function parameters assessed by the homeostasis model assessment (HOMA) and glycemic control, and their potential utilization in the clinical care of patients with type 2 diabetes mellitus. MATERIAL AND METHOD: The HOMA indices were assessed in 204 (62 males, 142 females) type 2 diabetic outpatients aged 60.7 +/- 10.9 years. All patients were non-insulin treated for their diabetes. The correlation between variables including logarithmically transformed HOMA-%S and HOMA-%B, body mass index (BMI) and duration of diabetes to glycemic control were assessed The value of the disposition index (HOMA-%SxHOMA-%B) that best discriminated patients with good glycemic control (HbA1C < 7%) from those without (HbA1C > or = 7%) was determined. RESULTS: Both log (HOMA-%S) and log (HOMA-%B) were inversely related to HbA1C with comparable degrees of association (beta = -0.62, p < 0.001 and beta = -0.61, p < 0.001, respectively). The log-transformed disposition index of at least 3.57 had a sensitivity of 74.2% and a specificity of 67.6% in classifying patients as having HbA1C < 7%. The result suggested that in order to achieve acceptable glycemic control, oral hypoglycemic agents should be adjusted to maximize the likelihood of the log-transformed disposition index reaching 3.57. CONCLUSIONS: Glycemic control in diabetic patients partially depends on both insulin sensitivity and pancreatic beta-cell function. Assessing both parameters with the HOMA model is likely to result in a more rational approach for achieving better glycemic control in type 2 diabetic patients.

Description

Chotmaihet Thangphaet.

Citation

Dansuntornwong B, Chanprasertyothin S, Jongjaroenprasert W, Ngarmukos C, Bunnag P, Puavilai G, Ongphiphadhanakul B. The relation between parameters from homeostasis model assessment and glycemic control in type 2 diabetes. Journal of the Medical Association of Thailand. 2007 Nov; 90(11): 2284-90