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Glucose effectiveness and insulin sensitivity measurements derived from the non‐insulin‐assisted minimal model and the clamp techniques are concordant
Author(s) -
Henriksen Jan Erik,
Alford Frank,
Ward Glenn,
ThyeRønn Peter,
Levin Klaus,
HotherNielsen Ole,
Rantzau Christian,
Boston Ray,
BeckNielsen Henning
Publication year - 2010
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.1127
Subject(s) - clamp , insulin , endocrinology , basal (medicine) , medicine , glucose clamp technique , insulin sensitivity , chemistry , insulin resistance , computer science , clamping , computer vision
Background We investigated the concordance between glucose effectiveness (SG) and insulin sensitivity (SI), derived from the unmodified dynamic non‐insulin‐assisted intravenous glucose tolerance test (IVGTT) implemented by SG MM and SI MM ; simulation analysis and modelling/conversational interaction (SAAM/CONSAM) versus the eu/hyperglycaemic basal insulinaemic and the euglycaemic hyperinsulinaemic clamp (SG CLAMP and SI CLAMP ). Methods Twenty‐seven of 30 normoglycaemic subjects completed a (1) euglycaemic hyperinsulinaemic clamp, (2) 6‐h eu/hyperglycaemic near‐normoinsulinaemic pancreatic clamp with hyperglycaemia present over the final 2 h of the clamp (Day 2 study), (3) identical clamp to (2) but with euglycaemia maintained over the entire 6 h (Day 3 study) and (4) IVGTT. SG CLAMP was calculated in two ways based on data from study (2) alone (Day 2 SG CLAMP210–240′ ) or from data from study day (2) and (3) (Day 2–3 SG CLAMP330–360′ ). Results SG MM was unrelated to the magnitude of endogenous insulin release (AIR). The single‐day (Day 2) and two‐day (Day 2 and 3) SG CLAMP protocols correlated ( r = 0.72, p = 0.003), but SG CLAMP210–240′ was significantly ( p = 0.001) higher than SG CLAMP330–360′ . Employing the Day 2 and 3 SG CLAMP protocol, the whole body SG CLAMP330–360′ was similar to SG MM (1.80 ± 0.82 versus 1.73 ± 0.58 dL/min) and correlated ( r = 0.45, p < 0.02). SG CLAMP210–240′ did not correlate with SG MM ( r = 0.24). SI MM and SI CLAMP were similar (0.093 ± 0.060 versus 0.087 ± 0.029 dL/min per mU/L) and correlated ( r = 0.76, p < 0.001). Conclusions The time‐dependent increase in glucose disposal observed during a prolonged 6‐h clamp significantly influences the estimation of SG CLAMP , and significant concordance coefficients are observed between SG MM , and SG CLAMP330–360′ , and SI MM and SI CLAMP . Copyright © 2010 John Wiley & Sons, Ltd.