The Roles of Insulin Secretion, Insulin Resistance and Glucose Effectiveness in Developing Diabetes in Non-Obese Old Women

Background: The impairment of glucose homeostasis are known to be attributed to the alterations of the four factors: first, second insulin secretion (FPIS, SPIS, respectively), glucose effectiveness (GE) and insulin resistance (IR). Objective: Older women were enrolled to investigate the relationships of the four factors with T2DM. Designs: A cross-sectional study. Settings: MJ Health Screening Center in Taiwan Patients and Methods: They were divided into normal glucose tolerance (NGT) and T2DM groups. Receiver operating characteristic (ROC) curve was performed and two models were built: Model 1: FPIS + GE and, Model 2: FPIS + GE + SPIS. Main Outcome Measures: The area under ROC curve (AUC) was used to predict type 2 DM. Sample Size: 644 non-obese women. Results: The AUC of SPIS was significantly higher than the diagonal line followed by GE and FPIS. Model 2 had the greatest AUC (0.968). An equation was built (-0.012-FPIS – 1003.9-GE – 119.4-SPIS + 20.7). It could predict the chance of having T2D with a sensitivity = 94.2% and specificity = 86.4%. Conclusions: SPIS is the most important contributor for T2DM in older women. The equation built from this model composed of FPIS, SPIS and GE could predict T2DM accurately.