Publication: The relation between parameters from homeostasis model assessment and glycemic control in type 2 diabetes
Issued Date
2007-11-01
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ISSN
01252208
01252208
01252208
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2-s2.0-37149046764
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol.90, No.11 (2007), 2284-2290
Suggested Citation
Bantita Dansuntornwong, Suwannee Chanprasertyothin, Wallaya Jongjaroenprasert, Chardpraon Ngarmukos, Pongamorn Bunnag, Gobchai Puavilai, Boonsong Ongphiphadhanakul The relation between parameters from homeostasis model assessment and glycemic control in type 2 diabetes. Journal of the Medical Association of Thailand. Vol.90, No.11 (2007), 2284-2290. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/24680
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Title
The relation between parameters from homeostasis model assessment and glycemic control in type 2 diabetes
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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 ≥ 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.