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Assessing Insulin Sensitivity in People with Type 1 Diabetes Without Euglycemic-Hyperinsulinemic Clamps

Biomarkers in Diabetes

  • 64 Accesses

Abstract

The euglycemic-hyperinsulinemic clamp is the “gold standard” in assessing insulin sensitivity. Due to high demands on the subject, need for experienced and skilled operators, and high costs, it remains predominantly a research tool. Multiple mathematical formulae have been developed to estimate insulin sensitivity using various biomarkers. Most variables used reflect body habitus, blood pressure, HbA1c, and lipids. Although most show relatively good correlation with insulin sensitivity measures from the euglycemic-hyperinsulinemic clamp series they are derived from, relatively few are validated using independent clamp datasets. Associations with other factors, which are usually mechanistically related to insulin resistance, such as inflammation and adiposity (reflected by adipokine levels) are also of interest, as these as well as clinical markers may suggest therapeutic targets.

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Abbreviations

BMI:

Body mass index

DBP:

Diastolic blood pressure

dur:

Duration

e:

Estimated

ffm:

Free fat mass

FL:

Fluorescence

G:

Glucose concentration

GDR:

Glucose disposal rate

GFR:

Glomerular filtration rate

HbA1:

Glycated hemoglobin

HbA1c:

Glycated hemoglobin

HDL-C:

High-density lipoprotein cholesterol

HOMA:

Homeostatic model assessment

HT:

Hypertension

I:

Insulin concentration

ICAM:

Intercellular cell adhesion molecule 1

IS:

Insulin sensitivity

ISI:

Insulin sensitivity index

ln:

Natural logarithm

M:

Metabolized glucose

MCR:

Metabolic clearance rate

mM:

mmol/L

OGTT:

Oral glucose tolerance test

PP:

Pulse pressure

QUICKI:

Quantitative insulin sensitivity check index

RAGE:

Receptor for advanced glycation end products

Si:

Sensitivity index

T1D:

Type 1 diabetes

TDD:

Total daily dose of insulin

TG:

Triglycerides

VAI:

Visceral adiposity index

WC:

Waist circumference

WH:

Waist-to-height ratio

WHR:

Waist-to-hip ratio

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Authors and Affiliations

  1. NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, Australia

    Andrzej S. Januszewski

  2. Department of Medicine, University of Melbourne, Fitzroy, VIC, Australia

    Andrzej S. Januszewski & Alicia J. Jenkins

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  1. Andrzej S. Januszewski
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Correspondence to Andrzej S. Januszewski .

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  1. Department of Biomedical Sciences, University of Westminster, London, UK

    Vinood B. Patel

  2. Franklin-Wilkins Bldg, Rm 4.101, 4th Fl, Kings Coll London, Sch Biomed Health Sci, London, UK

    Victor R. Preedy

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Januszewski, A.S., Jenkins, A.J. (2022). Assessing Insulin Sensitivity in People with Type 1 Diabetes Without Euglycemic-Hyperinsulinemic Clamps. In: Patel, V.B., Preedy, V.R. (eds) Biomarkers in Diabetes. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Cham. https://doi.org/10.1007/978-3-030-81303-1_18-1

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    Assessing Insulin Sensitivity in People with Type 1 Diabetes Without Euglycemic-Hyperinsulinemic Clamps
    Published:
    12 January 2023

    DOI: https://doi.org/10.1007/978-3-030-81303-1_18-2

  2. Original

    Assessing Insulin Sensitivity in People with Type 1 Diabetes Without Euglycemic-Hyperinsulinemic Clamps
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    24 August 2022

    DOI: https://doi.org/10.1007/978-3-030-81303-1_18-1

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