Insulin Resistant State in Type 2 Diabetes Is Related to Advanced Autonomic Neuropathy

To elucidate the relationships between obesity, glycemic control, dyslipidemia, hypertension, microvascular complications, and insulin resistance assessed using an euglycemic hyperinsulinemic clamp technique, we studied 54 hospitalized type 2 diabetic subjects (DM) and 10 age‐ and sex‐matched normotensive, nonobese control subjects (C). Glucose infusion rate (GIR) derived from the clamp study was used as an index of insulin resistance. Body mass index (BMI), the prevalence of hypertension, HbA1c and serum nonesterified fatty acids (NEFA) were significantly higher, and serum high‐density‐lipoprotein (HDL)‐cholesterol was significantly lower in DM than in C (p < 0.05 or less). The median GIR level was significantly lower in DM than in C (p = 0.038). The difference in GIR between the two groups was still statistically significant even after adjustment for BMI, mean BP, HbA1c, NEFA, and HDL‐cholesterol. However, after simultaneous adjustment for these factors, there was no difference in GIR between the two gr...