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June 7, 2026Diabetes

Indexes calculated from OGTTs performed best for predicting T2D (Gutt index highest), while QUICKI and HOMA-IR were best among fasting measures, and SPISE best among non-insulin measures.

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Why the study?

Which surrogate index of insulin resistance best predicts incident type 2 diabetes in diverse US cohorts?

Population

7,545 individuals from 5 diverse US cohorts with oral glucose tolerance test data, including Blacks, Whites…

Comparison

17 surrogate indexes of insulin resistance vs Comparison among the 17 different surrogate…

Design

Cohort

Follow-up

118,000 person-years

Authors

LVLAURA M. VAZQUEZEAElsa Vazquez ArreolaRDRAVINDRANATH A. DUGGIRALA

Discussion

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Overview

Surrogate measures of insulin resistance based on OGTTs are superior to fasting or non-insulin measures for predicting incident type 2 diabetes.

Key Points

  • This research aims to identify effective surrogate indexes of insulin resistance for predicting type 2 diabetes across multiple cohorts.
  • Analyzed data from 5 US cohorts with oral glucose tolerance tests (OGTTs) involving diverse populations.
  • Calculated 17 indexes of insulin resistance based on fasting and 2-hour glucose and insulin levels.
  • Evaluated predictive performance using hazard ratios (HR), area under the receiver operating characteristic curve (ΔAUC), and net reclassification information (NRI).
  • Identified 1628 new cases of type 2 diabetes over 118K years of follow-up.
  • Indexes derived from OGTTs showed superior predictive capabilities, with Gutt index exhibiting the highest predictive properties.
  • QUICKI and HOMA-IR achieved nearly identical NRI and ΔAUC in fasting insulin-only indexes, while SPISE was best among those not requiring insulin.

Structured PICO

Which surrogate index of insulin resistance best predicts incident type 2 diabetes in diverse US cohorts?

P
Population
7,545 individuals from 5 diverse US cohorts (ARIC, CARDIA, SAMAFS) with oral glucose tolerance test (OGTT) data, including Blacks (n=1,540), Whites (n=4,785), and Hispanics (n=1,220).
I
Intervention
17 surrogate indexes of insulin resistance (including OGTT-based, fasting insulin-based, and non-insulin-based measures)
C
Comparator
Comparison among the 17 different surrogate indexes
O
Outcome
Incident type 2 diabetes (assessed by hazard ratios per SD, change in AUC, and net reclassification information)hard clinical

Surrogate measures of insulin resistance based on OGTTs are superior to fasting or non-insulin measures for predicting incident type 2 diabetes.

Cite This Study

VAZQUEZ et al. (2026) studied this question.

synapsesocial.com/papers/6a250c027def13d035e1c118https://doi.org/10.2337/db26-2235-p
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 12254-P: Comparing Seven Adiposity Indexes in Their Ability to Predict Type 2 Diabetes Risk across Five U.S. Cohorts2026
  2. 2Beyond HOMA-IR: Comparative Evaluation of Insulin Resistance and Anthropometric Indices Across Prediabetes and Type 2 Diabetes Mellitus in Metabolic Syndrome Patients2025 · 2 citations
  3. 3Mini-review on insulin resistance assessment: Advances in surrogate indices and clinical applications2025
  4. 4Comparison of nine insulin resistance surrogates for predicting cardiovascular disease: a cohort study2025 · 10 citations
  5. 5Association of insulin resistance-related indexes with atherosclerotic cardiovascular disease: A crosss-sectional study2025