632-P: Beta-Cell Function Is a Stronger Predictor Than Insulin Resistance for Development of Type 2 Diabetes in Obese Indian Population—A Matched-Pair Cohort Analysis

Background: Insulin resistance is often thought to be the primary factor in the development of type 2 diabetes, especially in obese individuals.

Aim: To determine the relationship between the homeostatic assessment model and diabetes, as well as the associated comorbidities, using matched-pair analysis in an obese Indian population.

Methods: The present study retrospectively analyzed data from 451 gender-age-BMI matched pairs (with and without diabetes) of obese patients (BMI > 25 kg/m², aged 40-60 years) enrolled in a one-year online lifestyle intervention program at the Freedom from Diabetes Clinic, India. Baseline anthropometric data, biochemical parameters, and medical history were used for the analysis. The homeostatic assessment model was used to calculate HOMA-IR and HOMA2-B. Insulin resistance was defined as HOMA-IR>2.5, while good beta cell function was defined as HOMA2-B >50.

Results: The mean age and BMI of the patients was 47.7±5.7 years and 31±4.5 kg/m², respectively; patients with diabetes had a mean disease duration of 7.9 years. Patients with diabetes had a significantly higher prevalence of insulin resistance (72.5%), inflammation (hs-CRP >3) (62%), hypertension (36%), and dyslipidemia (43%) than those without diabetes (37.5%, 47%, 27%, and 22%, respectively) (p<0.05). In contrast, good beta-cell function was observed in those without diabetes (96%) than those with diabetes (55.4%; 81% of them were on OHA) (p<0.05).

Conclusion: The majority of matched patients without diabetes exhibited good beta cell function. These findings emphasize that beta-cell function rather than insulin resistance may be the primary deficit leading to the development of diabetes in obese individuals.