Comparison of Various Indices in Identifying Insulin Resistance and Diabetes in Chronic Spinal Cord Injury

Journal of Clinical Medicine, 2021 · DOI: https://doi.org/10.3390/jcm10235591 · Published: November 28, 2021

Simple Explanation

This study looks at different ways to measure how well the body uses insulin in people with long-term spinal cord injuries. Insulin resistance can lead to type 2 diabetes. Researchers compared several common methods like HOMA, QUICKI, and HbA1c to a more complex test called IVGTT, which is considered the gold standard for measuring insulin sensitivity. The goal was to see which of the simpler methods best matched the results of the IVGTT in people with spinal cord injuries, helping doctors choose the best screening tools.

Study Duration

3 years

Participants

29 individuals with chronic motor complete SCI

Evidence Level

Not specified

Key Findings

1
QUICKI (Quantitative Insulin-sensitivity Check Index) showed the strongest agreement with insulin sensitivity (Si) as measured by the IVGTT.
2
FPG (fasting plasma glucose) and HbA1C (hemoglobin A1C), common clinical markers, had the weakest agreement with IVGTT-measured Si.
3
HOMA also showed good agreement with IVGTT-assessed Si, ranking second to QUICKI in predictive accuracy.

Research Summary

This study evaluated various indices of glucose metabolism in individuals with chronic motor complete SCI to determine their agreement with IVGTT-measured insulin sensitivity (Si). The findings indicated that QUICKI had the strongest agreement with Si, suggesting its potential as a superior screening tool in this population. Common clinical markers like FPG and HbA1C showed the poorest agreement with IVGTT, highlighting the need for caution when relying solely on these markers for diagnosis in SCI patients.

Practical Implications

Improved Screening

QUICKI can be a valuable tool for more accurately identifying insulin resistance and diabetes in individuals with SCI, potentially leading to earlier intervention.

Clinical Practice

Clinicians should consider using QUICKI in addition to or instead of FPG and HbA1C when screening for glucose dysregulation in SCI patients.

Future Research

Further studies are needed to establish SCI-specific cutoff values for QUICKI and to explore the combined use of HbA1C and FPG for improved diagnostic precision.

Study Limitations

1
Small sample size
2
Lack of a control group without SCI
3
Reliance on fasting insulin values, which have inherent biological variability

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