Design and clinical pilot testing of the model-based Dynamic Insulin Sensitivity and Secretion Test (DISST)

Type of content
Journal Article
Publisher's DOI/URI
Thesis discipline
Degree name
Publisher
University of Canterbury. Electrical and Computer Engineering
University of Canterbury. Mechanical Engineering
Journal Title
Journal ISSN
Volume Title
Language
Date
2010
Authors
Lotz, T.F.
Chase, Geoff
McAuley, K.A.
Shaw, Geoff
Docherty, P.D.
Berkeley, J.E.
Williams, S.M.
Hann, C.E.
Mann, J.I.
Abstract

Background: Insulin resistance is a significant risk factor in the pathogenesis of type 2 diabetes. This article presents pilot study results of the dynamic insulin sensitivity and secretion test (DISST), a high-resolution, low-intensity test to diagnose insulin sensitivity (IS) and characterize pancreatic insulin secretion in response to a (small) glucose challenge. This pilot study examines the effect of glucose and insulin dose on the DISST, and tests its repeatability. Methods: DISST tests were performed on 16 subjects randomly allocated to low (5 g glucose, 0.5 U insulin), medium (10 g glucose, 1 U insulin) and high dose (20 g glucose, 2 U insulin) protocols. Two or three tests were performed on each subject a few days apart. Results: Average variability in IS between low and medium dose was 10.3% (p = .50) and between medium and high dose 6.0% (p = .87). Geometric mean variability between tests was 6.0% (multiplicative standard deviation (MSD) 4.9%). Geometric mean variability in first phase endogenous insulin response was 6.8% (MSD 2.2%). Results were most consistent in subjects with low IS. Conclusions: These findings suggest that DISST may be an easily performed dynamic test to quantify IS with high resolution, especially among those with reduced IS.

Description
Citation
Lotz, T.F., Chase, J.G., McAuley, K.A., Shaw, G.M., Docherty, P.D., Berkeley, J.E., Williams, S.M., Hann, C.E., Mann, J.I. (2010) Design and clinical pilot testing of the model-based Dynamic Insulin Sensitivity and Secretion Test (DISST). Journal of Diabetes Science and Technology, 4(6), pp. 1408-1423.
Keywords
insulin resistance, insulin sensitivity, type 2 diabetes diagnosis, physiological modeling, pilot study
Ngā upoko tukutuku/Māori subject headings
ANZSRC fields of research
Fields of Research::32 - Biomedical and clinical sciences::3201 - Cardiovascular medicine and haematology::320102 - Haematology
Fields of Research::32 - Biomedical and clinical sciences::3202 - Clinical sciences::320208 - Endocrinology
Field of Research::11 - Medical and Health Sciences::1101 - Medical Biochemistry and Metabolomics
Field of Research::01 - Mathematical Sciences
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