Insulin Resistance in Type 2 Diabetes Mellitus: Pattern, Determinants, and Correlates in a Resource-Challenge Nigerian Setting

Abstract

A bstract Background: Insulin resistance (IR) is an obesity and inflammation-associated condition driving the rising global prevalence of hypertension, type 2 diabetes mellitus (T2DM), and dyslipidemia. It is a modifiable risk factor for cardiometabolic disease due to its association with sedentary lifestyle and smoking. Aims: To assess IR and its associations in T2DM. Materials and Methods: This cross-sectional study analyzed 200 T2DM patients’ data and assessed its correlates and predictors using logistic regression. Statistical analysis used: Statistical Package for Social Sciences 26. Results: The mean age of the 200 participants was 58.96 ± 8.32 years, 19 (9.5%) were smokers and 54 (27%) had diabetes for more than 10 years. The waist–hip ratio was higher in women than men, P = 0.04. The hypertensives were older and had higher IR than those without hypertension, P = 0.04 and P < 0.001, respectively. The IR was positively correlated with the atherogenic index of plasma (AIP) and atherogenic coefficient (AQ), P = 0.04 and P < 0.001, respectively. Abdominal obesity, hypertension, hypertriglyceridemia, elevated triglyceride glycemic index (TGI), and low alpha lipoprotein (HDL) were more common in women than men. The elderly had higher AIP, TGI, and lower HDL, P < 0.001, P < 0.001, and P = 0.001, respectively. IR was associated with kidney dysfunction ( P = 0.02). Smoking (OR 1.93, 95% CI 1.15–2.26), hypertension (OR 5.84, 95% CI 3.17–7.28), AIP (OR 8.23, 95% CI 2.58–8.14), and AQ (OR 11.63, 95% CI 4.07–13.47) independently predicted IR. Conclusion: IR contributes majorly to the rising global prevalence of hypertension, T2DM, and dyslipidemia. Its association with sedentary lifestyles and smoking makes it a modifiable risk factor for cardiometabolic and renal disease. All efforts are needed to curtail its rising trend.