Korean J Intern Med.  2019 Sep;34(5):1068-1077. 10.3904/kjim.2016.233.

Higher glucagon-to-insulin ratio is associated with elevated glycated hemoglobin levels in type 2 diabetes patients

• Lee M
• Kim M
• Park JS
• Lee S
• You J
• Ahn CW
• Kim KR
• Kang S

• KMID: 2457030
• DOI: http://doi.org/10.3904/kjim.2016.233

Abstract

BACKGROUND/AIMS
The importance of α-cell dysfunction in the pathogenesis of type 2 diabetes has re-emerged recently. However, data on whether relative glucagon excess is present in clinical settings are scarce. We aimed to investigate associations between glucagon-to-insulin ratio and various metabolic parameters.
METHODS
A total of 451 patients with type 2 diabetes naïve to insulin treatment were recruited. Using glucagon-to-insulin ratio, we divided subjects into quartiles according to both fasting and postprandial glucagon-to-insulin ratios.
RESULTS
The mean age of the subjects was 58 years, with a mean body mass index of 25 kg/m² The patients in the highest quartile of glucagon-to-insulin ratio had higher glycated hemoglobin (HbA1c) levels. HbA1c levels were positively correlated with both fasting and postprandial glucagon-to-insulin ratios. Subjects in the highest quartile of postprandial glucagon-to-insulin ratio were more likely to exhibit uncontrolled hyperglycemia, even after adjusting for confounding factors (odds ratio, 2.730; 95% confidence interval, 1.236 to 6.028; p for trend < 0.01).
CONCLUSIONS
Hyperglucagonemia relative to insulin could contribute to uncontrolled hyperglycemia in type 2 diabetes patients.

Keyword

Glucagon; Insulin; Hemoglobin A, glycosylated; Diabetes mellitus, type 2; Hyperglycemia

MeSH Terms

Body Mass Index
Diabetes Mellitus, Type 2
Fasting
Glucagon
Hemoglobin A, Glycosylated*
Humans
Hyperglycemia
Insulin
Glucagon
Hemoglobin A, Glycosylated
Insulin