Abstract 62: Relative contribution of insulin resistance and beta cell dysfunction in subjects with metabolic syndrome and new onset diabetes, as assessed by HOMA 2: A comparative analysis from a South Indian cohort

Background: Recent research subclassifies Type 2 Diabetes Mellitus based on pathogenesis viz. insulin resistance (IR) and beta cell dysfunction. The concept of early beta cell dysfunction and dysglycemia onset in Indians is well proven. Aims and Objectives: Primary objective: Compare IR and beta cell function (BCF) in normal subjects and those with metabolic syndrome (MetS) and new onset diabetes (DM) Secondary objective: Estimate prevalence of fatty liver and correlate with IR and BCF. Results: We studied 30 MetS, 17 DM and 65 normal subjects. When compared to normal subjects, MetS subjects had higher IR (Median Insulin IR 1.9 vs 1.24, P 0.005 and Median C-peptideIR 2.24vs 1.64) but similar C-peptide and Insulin HOMA2-BCF (p=0.522; p=0.581) DM compared to MetS had reduced Insulin BCF (Median Insulin BCF 70.1 vs 111.9; p 0.02) and similar Insulin IR (p=0.40) Fatty liver prevalence was higher in subjects with MetS and DM. Subjects with fatty liver had higher IR (Median Insulin IR 1.61 vs 1.2, P 0.02) and comparable Insulin BCF (p=0.54) Conclusions: Insulin resistance, not beta cell function, seems to be associated with fatty liver and transition of normal subjects to Metabolic Syndrome and subsequent Diabetes Mellitus.