Background: Patients with chronic kidney disease (CKD) are susceptible to hyperglycemia.
Aim: To study the prevalence of pre-diabetes in CKD patients and determine the contribution of insulin resistance (IR) versus beta-cell dysfunction in patients with CKD.
Methods: 45 consecutive nondiabetic CKD patients and 40 healthy subjects were included. Patients were divided into a normoglycemic (NG) and a pre-diabetic (PDM) group. IR was assessed by homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell function was assessed by proinsulin/insulin ratio and beta-cell%.
Results: The prevalence of PDM was 40%. The prevalence of high HOMA-IR was 22.2 and 77.8% in the NG and PDM groups. Compared to NG patients, the PDM group showed higher fasting plasma glucose, HOMA-IR, insulin, and proinsulin, while the prevalence of beta-cell dysfunction of 22.2% was lower than the 37% present in the NG group.
Conclusion: Increased IR, rather than beta-cell dysfunction, is the primary mechanism of PDM in CKD patients.
Copyright (c) 2008 S. Karger AG, Basel.