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Review of methods for measuring β‐cell function: D esign considerations from the R estoring I nsulin S ecretion ( RISE ) C onsortium
Author(s) -
Han Tamara S.,
Kahn Steven E.,
Utzschneider Kristina M.,
Buchanan Thomas A.,
Nadeau Kristen J.,
Zeitler Philip S.,
Ehrmann David A.,
Arslanian Silva A.,
Caprio Sonia,
Edelstein Sharon L.,
Savage Peter J.,
Mather Kieren J.
Publication year - 2018
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13005
Subject(s) - insulin , insulin sensitivity , type 2 diabetes , medicine , function (biology) , diabetes mellitus , computer science , insulin resistance , biology , endocrinology , microbiology and biotechnology
The R estoring I nsulin S ecretion ( RISE ) study was initiated to evaluate interventions to slow or reverse the progression of β‐cell failure in type 2 diabetes ( T2D ). To design the RISE study, we undertook an evaluation of methods for measurement of β‐cell function and changes in β‐cell function in response to interventions. In the present paper, we review approaches for measurement of β‐cell function, focusing on methodologic and feasibility considerations. Methodologic considerations included: (1) the utility of each technique for evaluating key aspects of β‐cell function (first‐ and second‐phase insulin secretion, maximum insulin secretion, glucose sensitivity, incretin effects) and (2) tactics for incorporating a measurement of insulin sensitivity in order to adjust insulin secretion measures for insulin sensitivity appropriately. Of particular concern were the capacity to measure β‐cell function accurately in those with poor function, as is seen in established T2D , and the capacity of each method for demonstrating treatment‐induced changes in β‐cell function. Feasibility considerations included: staff burden, including time and required methodological expertise; participant burden, including time and number of study visits; and ease of standardizing methods across a multicentre consortium. After this evaluation, we selected a 2‐day measurement procedure, combining a 3‐hour 75‐g oral glucose tolerance test and a 2‐stage hyperglycaemic clamp procedure, augmented with arginine.