HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tripathy, D. Articles by Groop, L. Search for Related Content PubMed PubMed Citation Articles by Tripathy, D. Articles by Groop, L. Social Bookmarking                What's this?

Importance of Obtaining Independent Measures of Insulin Secretion and Insulin Sensitivity During the Same Test

Results with the Botnia clamp

¹ Department of Endocrinology, University Hospital MAS, Lund University, Sweden
² Närpes Health Center, Närpes, Finland
³ Department of Medicine, University Hospital, Helsinki, Finland

OBJECTIVE—To validate and apply a method for independent assessment of insulin secretion and insulin sensitivity (S_I) during the same test; that is, an intravenous glucose tolerance test followed by a euglycemic-hyperinsulinemic clamp, also called the Botnia clamp. This test was then applied to nondiabetic subjects with (FH+) and without (FH-) a first-degree family history of diabetes.

RESEARCH DESIGN AND METHODS—The Botnia clamp measures the first-phase insulin response (FPIR) to 0.3g/kg glucose i.v. and insulin sensitivity (M-value) from a 2-h euglycemic clamp begun 60 min after the glucose bolus. The M-value obtained during the Botnia clamp was compared with M-values obtained during a regular euglycemic clamp without prior glucose bolus. Repeated tests were performed in random order in subjects with normal and abnormal glucose tolerance. Finally, the test was applied to subjects with and without a family history of type 2 diabetes.

RESULTS—S_I and insulin secretion from this test showed a high degree of reproducibility, and the M-value obtained with the Botnia clamp correlated strongly with the M-value from a euglycemic clamp without prior glucose bolus (r = 0.953, P < 0.005). FH+ subjects showed decreased S_I (P = 0.02), but similar FPIR, compared with FH- subjects. However, insulin secretion adjusted for the degree of insulin resistance was significantly impaired (P = 0.04).

CONCLUSIONS—In conclusion, the Botnia clamp provides reliable and independent measures of S_I and ß-cell function during the same test. As illustrated above, knowledge of the degree of S_I is mandatory when presenting data on insulin secretion.

Abbreviations: AIR, acute insulin response • CV, coefficient of variation • DI, disposition index • DR, discriminant ratio • EGP, endogenous glucose production • FFM, fat-free mass • FPIR, first-phase insulin response • FSIGT test, frequently sampled intravenous glucose tolerance test • HOMA, homeostasis model assessment • IGT, impaired glucose tolerance • IVGTT, intravenous glucose tolerance test • NGT, normal glucose tolerance • S_I, insulin sensitivity • WHO, World Health Organization

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				P. F. Svendsen, L. Nilas, K. Norgaard, J.-E. B. Jensen, and S. Madsbad Obesity, body composition and metabolic disturbances in polycystic ovary syndrome Hum. Reprod., September 1, 2008; 23(9): 2113 - 2121. [Abstract] [Full Text] [PDF]

				H. Staiger, A. Stancakova, J. Zilinskaite, M. Vanttinen, T. Hansen, M. A. Marini, A. Hammarstedt, P.-A. Jansson, G. Sesti, U. Smith, et al. A Candidate Type 2 Diabetes Polymorphism Near the HHEX Locus Affects Acute Glucose-Stimulated Insulin Release in European Populations: Results from the EUGENE2 study Diabetes, February 1, 2008; 57(2): 514 - 517. [Abstract] [Full Text] [PDF]

				S. B. Haugaard, O. Andersen, S. Madsbad, C. Frosig, J. Iversen, J. O. Nielsen, and J. F.P. Wojtaszewski Skeletal Muscle Insulin Signaling Defects Downstream of Phosphatidylinositol 3-Kinase at the Level of Akt Are Associated With Impaired Nonoxidative Glucose Disposal in HIV Lipodystrophy Diabetes, December 1, 2005; 54(12): 3474 - 3483. [Abstract] [Full Text] [PDF]

				S. B Haugaard, O. Andersen, F. Dela, J. J. Holst, H. Storgaard, M. Fenger, J. Iversen, and S. Madsbad Defective glucose and lipid metabolism in human immunodeficiency virus-infected patients with lipodystrophy involve liver, muscle tissue and pancreatic {beta}-cells Eur. J. Endocrinol., January 1, 2005; 152(1): 103 - 112. [Abstract] [Full Text] [PDF]

				S. A. Arslanian, F. Bacha, R. Saad, and N. Gungor Family History of Type 2 Diabetes Is Associated With Decreased Insulin Sensitivity and an Impaired Balance Between Insulin Sensitivity and Insulin Secretion in White Youth Diabetes Care, January 1, 2005; 28(1): 115 - 119. [Abstract] [Full Text] [PDF]

				P. Poulsen, K. Levin, I. Petersen, K. Christensen, H. Beck-Nielsen, and A. Vaag Heritability of Insulin Secretion, Peripheral and Hepatic Insulin Action, and Intracellular Glucose Partitioning in Young and Old Danish Twins Diabetes, January 1, 2005; 54(1): 275 - 283. [Abstract] [Full Text] [PDF]

				C. Cervin, B. Liljestrom, T. Tuomi, S. Heikkinen, J. S. Tapanainen, L. Groop, and C. M. Cilio Cosegregation of MIDD and MODY in a Pedigree: Functional and Clinical Consequences Diabetes, July 1, 2004; 53(7): 1894 - 1899. [Abstract] [Full Text] [PDF]