Modeled Insulin Sensitivity and Interstitial Insulin Action from a Pilot Study of Dynamic Insulin Sensitivity Tests
An accurate test for insulin resistance can delay or prevent the development of Type 2 diabetes and its complications. The current gold standard test, CLAMP, is too labor intensive to be used in general practice. A recently developed dynamic insulin sensitivity test, DIST, uses a glucose-insulin-C-peptide model to calculate model-based insulin sensitivity, SI. Preliminary results show good correlation to CLAMP. However both CLAMP and DIST ignore saturation in insulin-mediated glucose removal. This study uses the data from 17 patients who underwent multiple DISTs to investigate interstitial insulin action and its influence on modeled insulin sensitivity. The critical parameters influencing interstitial insulin action are saturation in insulin receptor binding, αG, and plasma-interstitial difiusion rate, nI . Very low values of αG and very low values of nI produced the most intra-patient variability in SI. Repeatability in SI is enhanced with modeled insulin receptor saturation. Future parameter study on subjects with varying degree of insulin resistance may provide a better understanding of different contributing factors of insulin resistance.
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Docherty, P.D.; Chase, J.G.; Hann, C.E.; Lotz, T.F.; Lin, J.; McAuley, K.A.; Shaw, G.M. (University of Canterbury. Electrical and Computer EngineeringUniversity of Canterbury. Mechanical Engineering, 2010)Background: Many insulin sensitivity (SI) tests identify a sensitivity metric that is proportional to the total available insulin and measured glucose disposal despite general acceptance that insulin action is saturable. ...
The Dynamic Insulin Sensitivity and Secretion Test (DISST) - a novel measure of insulin sensitivity McAuley, K.A.; Berkeley, J.E.; Docherty, P.D.; Lotz, T.F.; Te Morenga, L.A.; Shaw, G.M.; Williams, S.M.; Chase, J.G.; Mann, J.I. (University of Canterbury. Mechanical Engineering, 2011)Objective: To validate the methodology for the Dynamic Insulin Sensitivity and Secretion Test (DISST) and to demonstrate its potential in clinical and research settings. Methods: 123 men and women had routine clinical and ...
Subramanian, Kannan (University of Canterbury. Chemical and Process Engineering, 2014)Type 2 diabetes or adult onset diabetes, has been a global epidemic for the past two decades, and the number of new cases accelerates every year. Insulin resistance is one of the major factors behind this, wherein the ...