Utzschneider, Kristina M.Younes, NajiRasouli, NedaBarzilay, JoshuaBanerji, Mary AnnCohen, Robert M.Gonzalez, Erica V.Mather, Kieren J.Ismail-Beigi, FaramarzRaskin, PhilipWexler, Deborah J.Lachin, John M.Kahn, Steven E.GRADE Research Group2024-03-212024-03-212021Utzschneider KM, Younes N, Rasouli N, et al. Association of glycemia with insulin sensitivity and β-cell function in adults with early type 2 diabetes on metformin alone. J Diabetes Complications. 2021;35(5):107912. doi:10.1016/j.jdiacomp.2021.107912https://hdl.handle.net/1805/39395Aims: Evaluate the relationship between measures of glycemia with β-cell function and insulin sensitivity in adults with early type 2 diabetes mellitus (T2DM). Methods: This cross-sectional analysis evaluated baseline data from 3108 adults with T2DM <10 years treated with metformin alone enrolled in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) Study. Insulin and C-peptide responses and insulin sensitivity were calculated from 2-hour oral glucose tolerance tests. Regression models evaluated the relationships between glycemic measures (HbA1c, fasting and 2-hour glucose), measures of β-cell function and insulin sensitivity. Results: Insulin and C-peptide responses were inversely associated with insulin sensitivity. Glycemic measures were inversely associated with insulin and C-peptide responses adjusted for insulin sensitivity. HbA1c demonstrated modest associations with β-cell function (range: r −0.22 to −0.35). Fasting and 2-hour glucose were associated with early insulin and C-peptide responses (range: r −0.37 to −0.40) as well as late insulin and total insulin and C-peptide responses (range: r −0.50 to −0.60). Conclusion: Glycemia is strongly associated with β-cell dysfunction in adults with early T2DM treated with metformin alone. Efforts to improve glycemia should focus on interventions aimed at improving β-cell function.en-USPublisher PolicyBeta-cell functionInsulin sensitivityType 2 diabetesGlucose toleranceGlycemic controlArticle