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Assessment of insulin resistance in vivo: application to the study of type 2 diabetes.
Scheen, André; Lefebvre, Pierre
1992In Hormone Research, 38 (1-2), p. 19-27
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Keywords :
Blood Glucose/metabolism; Diabetes Mellitus, Type 2/blood/physiopathology; Glucose Clamp Technique; Glucose Tolerance Test; Humans; Insulin/pharmacology; Insulin Resistance; Metabolic Clearance Rate
Abstract :
[en] Besides insulin secretion, insulin sensitivity plays a key role in the feedback glucose-insulin closed loop. It can be altered in numerous physiological, pathological and pharmacological conditions. It can be estimated in vivo using methods that open the feedback loop (insulin suppression test, glucose clamp) or that analyze the closed loop by employing mathematical models of glucose kinetics. The most popular method is the euglycemic hyperinsulinemic glucose clamp. This test should be ideally coupled with a priming-constant infusion of a glucose tracer together with indirect calorimetry. This combination allows to study the glucose kinetics (Ra and Rd, and thus endogenous-mainly hepatic-glucose production) and its metabolism (oxidation or storage as glycogen), respectively. One alternative approach is the frequently sampled intravenous glucose tolerance test where the dynamic changes in plasma insulin and glucose levels are analyzed using the so-called 'minimal model' method. Noninsulin-dependent or type 2 diabetes is characterized by a significant defect in both insulin secretion and action. The insulin resistance is located at the liver site (increased glucose production) and at the peripheral tissues (decreased oxidation and, even more, defective storage of glucose in the muscles). This insulin resistance, which predominates at the postreceptor level, seems to be genetically determined but is worsened by weight excess and by hyperglycemia itself. This contributes to a vicious circle which aggravates progressively the severity of the disease.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Scheen, André  ;  Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale
Lefebvre, Pierre ;  Centre Hospitalier Universitaire de Liège - CHU > Diabétologie,nutrition, maladies métaboliques
Language :
English
Title :
Assessment of insulin resistance in vivo: application to the study of type 2 diabetes.
Publication date :
1992
Journal title :
Hormone Research
ISSN :
0301-0163
eISSN :
1423-0046
Publisher :
S. Karger, Basel, Switzerland
Volume :
38
Issue :
1-2
Pages :
19-27
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 05 June 2009

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