Estimated Glucose Disposal Rate in Egyptian Children and Adolescents with Type 1 Diabetes Mellitus in Relation to Their Renal Function

The estimated glucose disposal rate (eGDR) is a clinical score used for indirect assessment of insulin resistance. It is based on waist to hip ratio (WHR), hemoglobin A1c (HbA1c), and the presence or absence of hypertension. The present study aimed to investigate the relationship between the insulin resistance, assessed by eGDR, in T1DM children & adolescents and their renal functions. The study included 82 Egyptian patients with T1DM who were followed up in the Pediatric Diabetes Clinic of Ain Shams University, Cairo, Egypt. Their demographic, anthropometric measures and clinical data were recorded. Assessments of HbA1c, serum creatinine, serum cystatin C, calculated GFR, creatinine clearance, twenty-four-hour urinary albumin excretion (UAE), and urinary albumin/creatinine ratio were done for all studied participants, and the eGDR was calculated. Microalbuminuria was detected in nearly one third of patients and macroalbuminuria was present in approximately one quarter of patients. The eGDR was inversely related to the diabetes duration, and the lower level of eGDR was associated with presence of diabetic nephropathy (p=0.05, p=0.048 respectively). The best cutoff value of eGDR for predicting microalbuminuria and increased urine albumin excretion was ? 8.9 mg/kg/min. Patients with lower eGDR had significantly higher microalbumin level, 24 hour UAE, serum cystatin c, serum creatinine, lower creatinine clearance, and longer duration of DM. In conclusion, low eGDR level was associated with the presence of diabetic nephropathy, and it could predict the presence of microalbuminuria and increased 24 hour UAE.