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AIMS To investigate the clinical status of insulin resistance (IR) and its correlation with disease duration in patients with type 1 diabetes (T1D). MATERIALS AND METHODS Cross-sectional data from a T1D cohort were obtained (n=923). IR-related metabolic disorders including hypertension, obesity, and dyslipidemia were used as outcome variable to explore the cut-off point for estimated glucose disposal rate (eGDR) by restricted cubic spline (RCS) curve. Regression models were used for multivariate analysis on the clinical factors associated with IR. The correlation between the status of IR and diabetes duration was depicted with RCS curve. RESULTS IR-related metabolic disorders were observed in 39.4% of patients, with 9.1% met the criteria for metabolic syndrome. Specifically, patients with ≥10 years of T1D were more likely to have IR-related metabolic disorders (53.8% vs. 36.7%, p<0.05). The presence of IR, defined as an eGDR ≤ 9.0 mg/kg/min, were observed in 42.2% of patients. Patients with IR had longer diabetes duration (3.5 vs. 2.7, years, p=0.003) and higher insulin dose (0.5 vs. 0.4, units per kg per day, p<0.001). Moreover, the presence of IR showed a gradual increase during 10 years' disease duration and further analysis showed diabetes duration ≥10 years was a key element behind the development of IR and IR-related metabolic disorders. CONCLUSIONS The status of IR is common in T1D, especially in those with ≥10 years of disease duration. Therapies targeting at balancing glycemic control and IR will be needed to decrease the future risks of cardiovascular diseases in T1D. This article is protected by copyright. All rights reserved.