Inflammatory Markers and Their Association With Insulin Resistance in Indian Children and Young Adults With Type 1 Diabetes.

INTRODUCTION: Long-term hyperglycemia in type 1 diabetes (T1D) leads to inflammation, oxidative stress, and endothelial damage. Chronic degeneration may lead to higher levels of inflammatory markers. The present study aimed to evaluate inflammatory markers and their association with insulin resistance in Indian children and youth with T1D. It further explores the predictors of inflammatory markers in them. METHODS: 194 children and youth (11.6-17.5 years) with T1D for at least two years were included in this cross-sectional study. Standard questionnaires and protocols were used to obtain demographic data and laboratory findings. High-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) were analyzed as inflammatory markers. Insulin sensitivity was computed using parameters required for SEARCH. RESULTS: 14.4% were found to have insulin resistance. Those with insulin resistance were found to have significantly lower glycemic control (HbA1c) and lean body mass (LBM) Z-score. Also, those with insulin resistance had higher insulin requirement, altered albumin-to-creatinine ratio (ACR), low-density lipoprotein (LDL) cholesterol, and hypertension. hs-CRP, IL-6, and TNF-α were higher in those with higher insulin resistance. By linear regression, higher hs-CRP, ACR, LDL, HbA1c, and fat percentage were important predictors of insulin resistance. CONCLUSIONS: T1D with insulin resistance is associated with higher inflammatory markers and subsequent microvascular and macrovascular complications. Early screening and timely intervention are required to abate disease progression and hypertension and avoid end-stage kidney disease.