Determination of Insulin Secretory Defect and Insulin Sensitivity in Type 2 Diabetic Subjects in Bangladesh

Diabetes mellitus (DM) is defined as a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. This study was undertaken to explore the basic defect in type 2 diabetes patients in Bangladesh. This was an observational study with case control design, was conducted in the Biomedical Research Group, Research Division, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine Metabolic Disorders (BIRDEM), Dhaka, Bangladesh, during the period of July 2008 to June 2009. A total of 153 subjects were included in study of which 63 belonged to type 2 diabetes mellitus group and 90 were healthy controls. Fasting and 2 hours postprandial blood glucose, serum insulin, HOMA%B, HOMA%S, QuickI, Glucose /insulin ratio, TG were measured and age, BMI, WHR were recorded. Waist-hip ratio (WHR), was significantly higher in T2DM as compared to control subjects [WHR, mean±SD, 0.94±0.12 vs. 0.88±0.06, p<0.001]; Glucose and insulin ratio of T2DM was significantly higher as compared to control subject [Glu: Ins, Median (range) of 0.54 (0.17-2.33) vs. 0.37(0.06-1.52)]. Insulin secretion (HOMA%B) was significantly lower in diabetic as compared to control subjects [HOMA%B, median (range), 71(4.90-391) vs. 180(59-634) p<0.001]; The quantitative insulin sensitivity check Index (QUICKI) of diabetic subjects were significantly higher as compared to control [QUICKI median (range) 39.90(4.80-138.10) vs. 0.55(0.36-0.85), <0.001]. Triglyceride (TG) and cholesterol (Chol) were significantly higher [(mg/dl), (mean±SD), TG (142±80.14) vs. (142±80.14); Chol (189±50.76) vs. (172±45), p=0.029] in T2DM as compared to control subjects. Those with diabetes showed significant association with insulin secretory defect (HOMA%B, p=0.006) and insulin resistance as assessed by GINR (p<0.001) and QuickI (p<0.001) but not by HOMA%S (p=0.127). The present data suggest that both insulin secretory defect and insulin sensitivity are present in T2 diabetic subjects of Bangladesh.