Homeostasis model assessment is a reliable indicator of insulin resistanceduring follow-up of patients with type 2 diabetes

OBJECTIVE- To investigate the usefulness of the homeostasis model assessmen t as an index of insulin resistance (HOMA-IR) for evaluating the clinical c ourse of patients with type 2 diabetes. RESEARCH DESIGN AND METHODS- The usefulness of HOMA-IR and its relationship with insulin resistance assessed by the hyperinsulinemic-euglycemic clamp study (clamp IR) were evaluated in 55 Japanese patients with type 2 diabete s before and after treatment. The patients were subjected to diet (similar to1,440-1,720 kcal/day) and exercise therapy (walking 10,000 steps daily) f or 6 weeks during their hospitalization. RESULTS- Univariate regression analysis disclosed a significant correlation between log transformed HOMA-IR and log-transformed clamp IR before (r = - 0.613, P < 0.0001) and after (r = -0.734, P < 0.0001) treatment. Neither th e slopes (-0.71 +/- 0.12 vs. -0.79 +/- 0.09, F = 0.25, P = 0.61) nor the in tercepts (y-intercept = 1.67 vs. 1.70, x-intercept = 2.36 vs. 2.15, F = 0.0 2, P = 0.88) of the regression lines between HOMA-IR and clamp IR were sign ificantly different before and after treatment. There was a significant cor relation between the decrease in log-transformed HOMA-IR and the increase i n clamp IR during treatment (r = -0.617, P < 0.0001). CONCLUSIONS- HOMA-IR may constitute a useful method not only for diagnosing insulin resistance. but also for follow-up during the treatment of patient s with type 2 diabetes.