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이미영,고장현,남수민,정필문,성중경,김송이,신장열,신영구,정춘희 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.6
Purpose: The short insulin tolerance test is a simple and reliable method of estimating insulin sensitivity. This study was designed to compare the insulin sensitizing effects of thiazolidinediones (TZDs) on the degree of insulin resistance, determined by a short insulin tolerance test (Kitt) in type 2 diabetic patients. Patients and Methods: Eighty-three subjects (mean age=57.87±10.78) with type 2 diabetes mellitus were enrolled and received daily one dose of rosiglitazone (4mg) or pioglitazone (15mg). The mean follow-up duration was 25.39±9.66 months. We assessed insulin sensitivity using HOMA-IR and the short insulin tolerance test before and after TZDs treatment. Results: When we compared patients’ characteristics before and after TZDs treatment, the mean fasting glucose level was significantly decreased (183.27±55.04 to 137.35±36.42mg/dL, p<0.001) and the mean HbA1C level was significantly decreased (9.24±1.96 to 8.11±1.39%, p<0.001). Also, Kitt values were significantly increased (2.03±1.14 to 2.67±0.97%/min, p=0.003), whereas HOMA-IR was significantly decreased (2.98±0.68 to 1.04±0.24, p<0.05). When classifying insulin resistance by Kitt values, insulin resistant subjects’ values were increased (<2.5 %/min; 1.51±0.53%/min to 2.63±0.88, p<0.001), whereas the values decreased in insulin sensitive subjects (≥2.5%/min; 3.50± 0.75%/min to 2.75±1.12%/min, p=0.002). Conclusion: The glucose lowering effects of TZDs by improving insulin resistance could be determined by using Kitt. However, Kitt may be a beneficial tool to determine TZDs’ effects only when patients’ Kitt values are less than 2.5%/min.