Acidosis is associated with lower insulin sensitivity and incident type 2 diabetes in indigenous Americans: A prospective cohort study
Authors' conclusion
Acidosis was associated with lower insulin sensitivity and increased risk of type 2 diabetes that was attenuated by measures of lower insulin sensitivity. Acidosis as reflected by CAG may be a target for intervention.
Study context
- Population
- Healthy indigenous American adults without diabetes; baseline acidosis markers, insulin sensitivity by hyperinsulinaemic-euglycaemic clamp and body composition188 male
- Participants
- 296 adults
- Exposure
- Acid markers vs insulin sensitivity and incident T2D
- Outcome
- Association of acid markers with insulin sensitivity (M-low) and incident T2D
Methodological detailslongitudinal, cross-sectional analysis, Cox regression (per 1-SD change)
- Longitudinal
- Cross-sectional analysis
- Cox regression (per 1-SD change)
Main finding
As reported in the abstract
- Anion gap (AG) vs M-low, partial r (adjusted for age, sex, body fat %, eGFR)
- −0.22, p < 0.0001
- Corrected anion gap (CAG) vs M-low, partial r (adjusted for age, sex, body fat %, eGFR)
- −0.24, p < 0.0001
- Incident T2D during median follow-up 8.0 years
- 50 participants
- CAG and T2D risk, HR (adjusted for age, sex, body fat %, baseline plasma glucose)
- 1.32, 95% CI 1.01-1.74, p = 0.044
- CAG and T2D risk after further adjustment for M-low
- p = 0.17
Observational data: associations, not effects.
Original publication
Acidosis is associated with lower insulin sensitivity and incident type 2 diabetes in indigenous Americans: A prospective cohort study. Diabetes Obes Metab. Published 18 August 2025. doi:10.
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