Assessment of insulin action on carbohydrate metabolism: physiological and non‐physiological methods

Abstract

Carbohydrate metabolism in humans is regulated by insulin secretion from pancreatic β-cells and glucose disposal by insulin-sensitive tissues. Insulin facilitates glucose utilization in peripheral tissues and suppresses hepatic glucose production. Any defects in insulin action predispose an individual to glucose intolerance and Type 2 diabetes mellitus. Early detection of defects in insulin action could provide opportunities to prevent or delay progression of the disease state. There are different approaches to assess insulin action. Initial methods, such as peripheral insulin concentration and simple indices, have several limitations. Subsequently, researchers developed methodologies using intravenous glucose infusion to determine glucose fluxes. However, these methodologies are limited by being non-physiological. Newer, innovative techniques that have been developed are more sophisticated and physiological. By modelling glucose kinetics using isotope dilution techniques, several robust parameters can be obtained that are physiologically relevant and sound. This brief review summarizes most of the non-physiological and physiological methodologies used to measure the variables of insulin action.

Anti-diabetic effect of betulinic acid on streptozotocin-nicotinamide induced diabetic male mouse model

“…HOMA-IR was used to quantify insulin resistance and HOMA-β was used to quantify β-cell function. HOMA-β and QUICKI correlate with HOMA-IR (Dube et al, 2013). The results show that treatment with BA in STZ-NA diabetic mice decreased HOMA-IR compared with the control group.…”

The regulation of glucose metabolism: implications and considerations for the assessment of glucose homeostasis in rodents

“…A critical factor in metabolic research is the choice of methodology used to examine glucose homeostasis. Although there are a number of techniques available, many of which have been adapted from clinical use in humans, possibly the most important consideration is to recognize the key differences between "physiological" and "pseudophysiological" (i.e., euglycemic hyperinsulinemic clamp, intravenous or intraperitoneal glucose tolerance test, and intravenous insulin tolerance test) techniques to assess glucose metabolism (57). Under physiological conditions, such as during a meal or an oral glucose tolerance test (OGTT), ingested glucose is drained from the small intestine via the mesenteric vein into the portal vein and liver sinusoids.…”

Association between systemic oxidative stress and insulin resistance/sensitivity indices – the PREDIAS study

“…EPIR was estimated from fasting insulin, 30–min insulin and 30–min plasma glucose according to Stumvoll et al . DI, the product of EPIR and ISI, reflects the ability of the ß–cell to compensate for insulin resistance …”