The dynamic insulin sensitivity and secretion test—a novel measure of insulin sensitivity

Abstract

The objective was to validate the methodology for the dynamic insulin sensitivity and secretion test (DISST) and to demonstrate its potential in clinical and research settings. One hundred twenty-three men and women had routine clinical and biochemical measurements, an oral glucose tolerance test, and a DISST. For the DISST, participants were cannulated for blood sampling and bolus administration. Blood samples were drawn at t = 0, 10, 15, 25, and 35 minutes for measurement of glucose, insulin, and C-peptide. A 10-g bolus of intravenous glucose at t = 5 minutes and 1 U of intravenous insulin immediately after the t = 15 minute sample were given. Fifty participants also had a hyperinsulinemic-euglycemic clamp. Relationships between DISST insulin sensitivity (SI) and the clamp, and both DISST SI and secretion and other metabolic variables were measured. A Bland-Altman plot showed little bias in the comparison of DISST with the clamp, with DISST underestimating the glucose clamp by 0.1·10(-2)·mg·L·kg(-1)·min(-1)·pmol(-1) (90% confidence interval, -0.2 to 0). The correlation between SI as measured by DISST and the clamp was 0.82; the c unit for the receiver operating characteristic curve analysis for the 2 tests was 0.96. Metabolic variables showed significant correlations with DISST SI and the second phase of insulin release. The DISST also appears able to distinguish different insulin secretion patterns in individuals with identical SI values. The DISST is a simple, dynamic test that compares favorably with the clamp in assessing SI and allows simultaneous assessment of insulin secretion. The DISST has the potential to provide even more information about the pathophysiology of diabetes than more complicated tests.

Stochastic Modelling of Insulin Sensitivity for out of Hospital Cardiac Arrest Patients Treated with Hypothermia

“…This profile effectively describes patient-specific metabolic behavior under time-varying physiologic conditions. The validity and independence of this patient-specific parameter have been validated using data from independent, clinically matched cohorts (Chase et al 2010) and in gold-standard insulin sensitivity tests (McAuley et al 2011). …”

Use of the DISST Model to Estimate the HOMA and Matsuda Indexes Using Only a Basal Insulin Assay

“…18 The cohort was selected from volunteers in the Christchurch region of New Zealand. Each participant signed informed consent before participating in the study.…”

“…The cohort had a median age of 40 (IQR 19.5), and median BMI of 28.6 (IQR 2.64). Further information pertaining to the cohort can be found in McAuley et al 18 …”

“…Details of these protocols are provided in McAuley et al 18 The Matsuda Index. The Matsuda Index (ISI…”

A Proportional-Derivative Endogenous Insulin Secretion model with an Adapted Gauss Newton Approach

“…The DISST SI value is highly correlated to the EIC (R pearson = 0.81), and the test can contrast U N characteristics across patient groups with different levels of IR (McAuley et al 2011). The DISST defines the patient-specific U N based on deconvolution of measured C-peptide data.…”