scholarly journals Dynamic insulin sensitivity index: importance in diabetes

2010 ◽  
Vol 298 (3) ◽  
pp. E440-E448 ◽  
Author(s):  
Gianluigi Pillonetto ◽  
Andrea Caumo ◽  
Claudio Cobelli
Keyword(s):  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Insulin Action ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Diabetic Patients ◽  
Sensitivity Index ◽  
Insulin Sensitivity Index ◽  
Intravenous Glucose ◽  
Glucose Tolerant

The classical minimal model (MM) index of insulin sensitivity, SI, does not account for how fast or slow insulin action takes place. In a recent work, we proposed a new dynamic insulin sensitivity index, SID, which is able to take into account the dynamics of insulin action as well. The new index is a function of two MM parameters, namely SI and p2, the latter parameter governing the speed of rise and decay of insulin action. We have previously shown that in normal glucose tolerant subjects SID provides a more comprehensive picture of insulin action on glucose metabolism than SI. The aim of this study is to show that resorting to SID rather SI is even more appropriate when studying diabetic patients who have a low and slow insulin action. We analyzed insulin-modified intravenous glucose tolerance test studies performed in 10 diabetic subjects and mixed meal glucose tolerance test studies exploiting the triple tracer technique in 14 diabetic subjects. We derived both SI and SID resorting to Bayesian and Fisherian identification strategies. The results show that SID is estimated more precisely than SI when using the Bayesian approach. In addition, the less labor-intensive Fisherian approach can still be used to obtain reliable point estimates of SID but not of SI. These results suggest that SID yields a comprehensive, precise, and cost-effective assessment of insulin sensitivity in subjects with impaired insulin action like impaired glucose tolerant subjects or diabetic patients.

scholarly journals Leptin/Adiponectin Ratios Using Either Total Or High-Molecular-Weight Adiponectin as Biomarkers of Systemic Insulin Sensitivity in Normoglycemic Women

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Carolina Bravo ◽  
Luis Rodrigo Cataldo ◽  
José Galgani ◽  
Javier Parada ◽  
José Luis Santos
Keyword(s):  
Molecular Weight ◽  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
High Molecular Weight ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Sensitivity Index ◽  
High Molecular Weight Adiponectin ◽  
Intravenous Glucose ◽  
Negatively Associated

Plasma leptin/adiponectin ratio (LAR) is negatively associated with insulin sensitivity indexes. High-molecular-weight adiponectin (HMWA) was proposed as the most biologically active form of this insulin-sensitizing adipokine. There are no studies assessing the relative merits of leptin/HMWA ratio over LAR as a biomarker of systemic insulin sensitivity. A standard 2-hour oral glucose tolerance test (OGTT; 75 g of glucose) and a short minimal-model intravenous glucose tolerance test (IVGTT; 0.3 g/kg body weight) were performed in 58 Chilean normoglycemic women (age: 27 ± 6.3 years, BMI 23.6 ± 3.2 kg/m2). LAR was negatively associated with HOMA-S (r=−0.49; p<0.0001), Matsuda-ISICOMP (r=−0.54; p<0.0001), and the calculated sensitivity index (CSi) derived from IVGTT (r=−0.38; p=0.007). In comparison to LAR, leptin/HMWA ratio did not increase neither the linear fit (r2) nor the magnitude of association with insulin sensitivity indexes (slope of multiple linear regression). The discriminatory capacity of both ratios to classify insulin-resistant versus insulin-sensitive subjects was similar for HOMA-S (p=0.84), Matsuda-ISICOMP (p=0.43), or CSi (p=0.50). In conclusion, LAR showed consistent negative associations with different systemic insulin sensitivity indexes. The use of HMWA to generate leptin/HMWA ratio did not show any advantage over LAR as a biomarker of systemic insulin sensitivity in normoglycemic women.

scholarly journals Validation of Insulin Sensitivity Indices from Oral Glucose Tolerance Test Parameters in Obese Children and Adolescents

2004 ◽  
Vol 89 (3) ◽  
pp. 1096-1101 ◽  
Author(s):  
Catherine W. Yeckel ◽  
Ram Weiss ◽  
James Dziura ◽  
Sara E. Taksali ◽  
Sylvie Dufour ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Sensitivity Index ◽  
Intramyocellular Lipid ◽  
Insulin Sensitivity Index ◽  
Obese Youth ◽  
Intramyocellular Lipid Content

Abstract Given the extreme increase in prediabetes, type 2 diabetes, and the potential for metabolic syndrome in obese youth, identifying simplified indexes for assessing stimulated insulin sensitivity is critical. The purpose of this study was validation of two surrogate indexes of insulin sensitivity determined from the oral glucose tolerance test (OGTT): the composite whole body insulin sensitivity index (WBISI) and the insulin sensitivity index (ISI). An obese population (aged 8–18 yr) of normal and impaired glucose tolerance individuals was studied. One group (n = 38) performed both the euglycemic-hyperinsulinemic clamp and OGTT for comparison of insulin sensitivity measurements as well as 1H-magnetic resonance spectroscopy estimates of intramyocellular lipid content. Another larger (n = 368) cohort participated only in an OGTT. Both the WBISI and ISI represented good estimates (r = 0.78 and 0.74; P &lt; 0.0005) for clamp-derived insulin sensitivity (glucose disposed, M-value), respectively. In the large cohort, the surrogate indexes demonstrated the shift toward poorer function and increased risk profile as a function of insulin resistance. Additionally, the WBISI and ISI correlated with intramyocellular lipid content (r = −0.74 and −0.71; P &lt; 0.0001), a tissue marker for insulin resistance. Insulin sensitivity can be estimated using plasma glucose and insulin responses derived from the OGTT in obese youth with normal and impaired glucose tolerance.

scholarly journals Insulin Sensitivity and β-Cell Function in Protease Inhibitor-Treated and -Naive Human Immunodeficiency Virus-Infected Children

2005 ◽  
Vol 90 (1) ◽  
pp. 168-174 ◽  
Author(s):  
Ari Bitnun ◽  
Etienne Sochett ◽  
Paul T. Dick ◽  
Teresa To ◽  
Craig Jefferies ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Sensitivity Index ◽  
Insulin Sensitivity Index ◽  
Β Cell ◽  
The Mean ◽  
Visceral Adipose

Abstract Previous pediatric studies have failed to demonstrate a clear association between protease inhibitor (PI) therapy and abnormal glucose homeostasis in HIV-infected children. To define more precisely the impact of PI therapy on glucose homeostasis in this population, we performed the insulin-modified frequent-sampling iv glucose tolerance test on 33 PI-treated and 15 PI-naive HIV-infected children. Other investigations included fasting serum lipids; glucose, insulin, and C-peptide; single-slice abdominal computed tomography; and, in a subset of PI-treated children, an oral glucose tolerance test. There were no differences between the two groups with respect to fasting serum insulin or C-peptide, homeostatic model assessment insulin resistance, or quantitative insulin sensitivity check index. The mean insulin sensitivity index of PI-treated and PI-naive children was 6.93 ± 6.37 and 10.58 ± 12.93 × 10−4min−1 [μU/ml]−1, respectively (P = 0.17). The mean disposition index for the two groups was 1840 ± 1575 and 3708 ± 3005 × 10−4min−1 (P = 0.013), respectively. After adjusting for potential confounding variables using multiple regression analysis, the insulin sensitivity index and disposition index of PI-treated children were significantly lower than that of PI-naive children (P = 0.01 for both). In PI-treated but not PI-naive children, insulin sensitivity correlated inversely with visceral adipose tissue area (r = −0.43, P = 0.01) and visceral to sc adipose tissue ratio (r = −0.49, P = 0.004). Mildly impaired glucose tolerance was noted in four of 21 PI-treated subjects tested. Our results demonstrate not only that PI therapy reduces insulin sensitivity in HIV-infected children but also that it impairs the β-cell response to this reduction in insulin sensitivity and, in a subset of children, leads to the development of impaired glucose tolerance. The presence of insulin resistance, dyslipidemia, and the significant correlation of reduced insulin sensitivity with increased visceral adipose tissue content suggest that PI-containing highly active antiretroviral therapy is associated with the emergence of early features of a metabolic syndrome-like phenotype.

scholarly journals Novel Insulin Sensitivity Index Derived from Oral Glucose Tolerance Test

2003 ◽  
Vol 88 (3) ◽  
pp. 1019-1023 ◽  
Author(s):  
Supamai Soonthornpun ◽  
Worawong Setasuban ◽  
Atchara Thamprasit ◽  
Wanne Chayanunnukul ◽  
Chatchalit Rattarasarn ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Sensitivity Index ◽  
Oral Glucose Tolerance ◽  
Insulin Sensitivity Index

New insulin sensitivity index from the oral glucose tolerance test

2008 ◽  
Vol 79 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Youichiro Kazama ◽  
Toshinari Takamura ◽  
Masaru Sakurai ◽  
Hisakazu Shindo ◽  
Eizho Ohkubo ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Sensitivity Index ◽  
Oral Glucose Tolerance ◽  
Insulin Sensitivity Index

scholarly journals First-phase insulin response (FPIR) to intravenous glucose tolerance test (IVGTT), insulin sensitivity and long-term follow-up in ?- transfusion-dependent thalassemia (TDT) normoglycemic patients with reduced insulin secretion to oral glucose tolerance t

2021 ◽  
Vol 13 (1) ◽  
pp. e2021021
Author(s):  
Vincenzo De Sanctis
Keyword(s):  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Glucose Tolerance Test ◽  
Insulin Response ◽  
Tolerance Test ◽  
Intravenous Glucose Tolerance Test ◽  
Oral Glucose ◽  
Sensitivity Index ◽  
Intravenous Glucose

Summary. Objective: To  study the function of the endocrine pancreas in transfusion-dependent ?-thalassemia (?-TDT) patients with normal oral glucose tolerance test (OGTT) and hypoinsulinemia. Patients and methods: Seven ?-TDT patients  (mean age 22.4 ± 4.2 years) with normal glucose tolerance test (NGT) and poor insulin response (hypoinsulinemia) to OGTT,  not associated with ?-cell autoimmunity, were referred for a second opinion to an Italian Centre, part of the International Network of Clinicians for Endocrinopathies in Thalassemia and Adolescence Medicine (ICET-A). In this pilot study,  the first-phase insulin response (FPIR), expressed as the sum of 1 and  3 minutes insulin, of ?-TDT patients to intravenous glucose tolerance test (IVGTT), was tested. Moreover, the long-term natural history was followed prospectively using an annual OGTT, with the aim of detecting any abnormality of glucose metabolism. Results: The FPIR value  was between the 1st and 3rd percentile in two patients and between the 3rd and 10th percentile in  five. After 43 ± 26 months (range 11 - 80 months) of follow-up, 2 patients developed impaired glucose tolerance (IGT), 3 both IGT and impaired fasting glucose (IFG) and two overt diabetes mellitus (DM). Interestingly, the patients who developed DM had, at baseline the lowest value of insulinogenic index (IGI, 0.08 and 0.25), defined as the ratio of the increment of plasma insulin to plasma glucose during the first 30 minutes after OGTT. Moreover, a significant correlation was found between the IGI at baseline and at follow-up in the patients who developed IGT with or without IFG (R= 0.927; P: 0.023). A significant reduction of Matsuda insulin sensitivity index (ISIM) and Insulin Secretion-Sensitivity Index-2 (ISSI-2) was documented in the study cohort at diagnosis of IFG, IGT and DM. There was a significant inverse correlation between ISSI-2 and area under the curve of plasma glucose (AUC-PG). Conclusions: These data demonstrated, for the first time, a progressive deterioration in glucose homeostasis in ?-TDT subjects with NGT and hypoinsulinemia.  Thus, we consider that variations of insulin sensitivity could possibly have an impact on glucose tolerance in adult patients with TDT. Further investigations should focus on factors that might positively influence insulin sensitivity, including nutrition, drugs and physical activity.  

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