The kinetics of insulin in man. I. General aspects

Ferrannini, Eleuterio; Cobelli, Claudio

doi:10.1002/dmr.5610030201

Cited by 89 publications

(58 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…21,22 Fasting posthepatic insulin delivery rate was then obtained as the product of post-hepatic insulin clearance rate by the fasting plasma insulin concentration. Post-OGTT posthepatic insulin delivery was calculated as the product of insulin clearance and the OGTT area under insulin curve on the assumption that post-hepatic insulin clearance is unchanged during glucose absorption.…”

Section: Discussionmentioning

confidence: 99%

Influence of duration of obesity on the insulin resistance of obese non-diabetic patients

et al. 1998

View full text Add to dashboard Cite

OBJECTIVE: To investigate whether duration of obesity has an independent impact on insulin resistance. DESIGN: Case-control study. SUBJECTS: 30 non-diabetic obese subjects (age, 34 AE 2 y, body mass index (BMI), 33.5 AE 0.8 kg Á m 72 ) with a range (1±35 y) of self-reported duration of obesity, and 12 age-and gender-matched non-obese controls (BMI, 22.1 AE 0.6 kg Á m 72 ). MEASUREMENTS: Oral glucose tolerance (40 g Á m 72 ), insulin sensitivity (by the euglycaemic insulin clamp technique), and insulin secretion (as the product of post-hepatic insulin clearance and plasma insulin concentration). RESULTS: The obese group presented hyperinsulinaemia in the basal state and after glucose loading (insulin area 58 AE 5 vs 33 AE 3 nmol Á l 71 Á 2 h, P 0.005), insulin resistance (M value 37.4 AE 4.8 vs 50.6 AE 2.6 m mmol Á min 71 Á kg FFM 71 , P 0.002), and insulin hypersecretion (61.9 AE 6.0 vs 33.9 AE 4.0 nmol Á 2 h, P 0.007); endogenous glucose production was similar in the two groups. In the whole dataset, insulin resistance was directly related to BMI, the waist-to-hip ratio (WHR), endogenous glucose production, insulin secretion, and fasting serum triglycerides and uric acid concentrations. When the obese subjects were strati®ed by duration of obesity, insulin resistance was progressively lower with longer obesity duration (P 0.04). When simultaneously adjusting by age, gender and BMI, obesity duration was independently associated with greater insulin sensitivity (P 0.003), lower plasma insulin response to oral glucose (P 0.001), and lower fasting and glucose-stimulated insulin release (P 0.01 for both). CONCLUSIONS: In obese subjects with preserved glucose tolerance, duration of obesity is associated with better insulin sensitivity irrespective of the degree of overweight.

show abstract

Section: Discussionmentioning

confidence: 99%

Influence of duration of obesity on the insulin resistance of obese non-diabetic patients

et al. 1998

View full text Add to dashboard Cite

show abstract

“…This model also has relatively simple insulin kinetics compared to other more extensive models [50,51,52,53]. It does not explicitly express different routes of insulin clearance and transport from plasma.…”

Section: Icu Modelġmentioning

confidence: 99%

A physiological Intensive Control Insulin-Nutrition-Glucose (ICING) model validated in critically ill patients

Lin

Razak

Pretty

et al. 2011

Computer Methods and Programs in Biomedicine

190

149

View full text Add to dashboard Cite

show abstract

“…The vast majority of the published data pertaining to beta cell function are expressed as plasma insulin concentrations [15]. Beside the problems posed by the variability and specificity (versus proinsulin and its split products) of insulin assays [16], circulating insulin concentrations are dependent upon beta cell insulin release through insulin distribution and clearance [17]. In general, the total-body volume of distribution of the hormone does not seem to vary with the insulin secretion rate, whereas whole-body insulin clearance (mostly by hepatic and renal degradation) can be regulated by the insulin concentration itself (i.e.…”

Section: In Vivo Tests Of Insulin Secretionmentioning

confidence: 99%

Beta cell function and its relation to insulin action in humans: a critical appraisal

2004

View full text Add to dashboard Cite

The importance of both insulin resistance and beta cell dysfunction in the pathogenesis of glucose intolerance is widely recognised. Also popular is the concept that beta cell secretory function must be viewed in the context of extant insulin resistance. This For Debate moves from the premise that, whilst insulin action in vivo can be measured directly by a variety of essentially coherent techniques, measurement of beta cell function is more problematic. We therefore concisely survey the principal in vivo techniques that explore the diverse aspects of beta cell function and conclude that: (i) inter-correlation of clinical tests is only modest in non-diabetic subjects and poor in diabetic individuals; (ii) no single clinical test allows beta cell function to be assessed with accuracy and specificity comparable to those of insulin sensitivity; and (iii) short of complex experiments, mathematical modelling is necessary to interpret insulin secretory responses. Next we discuss the hyperbola paradigm used to describe the reciprocal relation of beta cell function to insulin sensitivity and suggest that: (i) insulin responses reflecting the basal beta cell tone are indeed inversely related to insulin action across degrees of glucose intolerance; (ii) modes of beta cell function that selectively reflect the dynamic response to acutely changing glucose concentrations are largely independent of insulin action; and (iii) when measured by experiment or resolved by modelling, quantitatively the most important of these dynamic secretion parameters is the glucose dose-response curve (glucose sensitivity). In fact, glucose excursions following glucose ingestion (i.e. glucose tolerance) are best explained by dynamic parameters of beta cell function. Abbreviations: AIR, acute insulin response · DI, disposition index · GLP-1, glucagon-like peptide-1 · ISR, insulin secretion rate · M, whole-body insulin-mediated glucose uptake · MCR, metabolic clearance rate Diabetologia (2004) 47:943-956

show abstract

The kinetics of insulin in man. I. General aspects

Cited by 89 publications

References 71 publications

Influence of duration of obesity on the insulin resistance of obese non-diabetic patients

Influence of duration of obesity on the insulin resistance of obese non-diabetic patients

A physiological Intensive Control Insulin-Nutrition-Glucose (ICING) model validated in critically ill patients

Beta cell function and its relation to insulin action in humans: a critical appraisal

Contact Info

Product

Resources

About