An insulin-modified frequently sampled intravenous glucose tolerance test (FSIGTT) with minimal model analysis was compared with the glucose clamp in 11 subjects with normal glucose tolerance (NGT), 20 with impaired glucose tolerance (IGT), and 24 with non-insulin-dependent diabetes mellitus (NIDDM). The insulin sensitivity index (SI) was calculated from FSIGTT using 22- and 12-sample protocols (SI(22) and SI(12), respectively). Insulin sensitivity from the clamp was expressed as SI(clamp) and SIP(clamp). Minimal model parameters were similar when calculated with SI(22) and SI(12). SI could not be distinguished from 0 in ∼ 50% of diabetic patients with either protocol. SI(22) correlated significantly with SI(clamp) in the whole group (r = 0.62), and in the NGT (r = 0.53), IGT (r = 0.48), and NIDDM (r = 0.41) groups (P < 0.05 for each). SI(12) correlated significantly with SI(clamp) in the whole group (r = 0.55, P < 0.001) and in the NGT (r = 0.53, P = 0.046) and IGT (r = 0.58, P = 0.008) but not NIDDM (r = 0.30, P = 0.085) groups. When SI(22), SI(clamp), and SIP(clamp) were expressed in the same units, SI(22) was 66 ± 5% (mean ± SE) and 50 ± 8% lower than SI(clamp) and SIP(clamp), respectively. Thus, minimal model analysis of the insulin-modified FSIGTT provides estimates of insulin sensitivity that correlate significantly with those from the glucose clamp. The correlation was weaker, however, in NIDDM. The insulin-modified FSIGTT can be used as a simple test for assessment of insulin sensitivity in population studies involving nondiabetic subjects. Additional studies are needed before using this test routinely in patients with NIDDM.
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Original Articles|
September 01 1994
A Comparison Between the Minimal Model and the Glucose Clamp in the Assessment of Insulin Sensitivity Across the Spectrum of Glucose Tolerance
Mohammed F Saad;
Mohammed F Saad
Departments of Medicine, University of Southern California Medical School
Los Angeles, California
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Randy L Anderson;
Randy L Anderson
The Department of Public Health Sciences, Bowman Gray School of Medicine
Winston-Salem, North Carolina
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Ami Laws;
Ami Laws
Department of Medicine, Stanford University Medical School
Stanford, California
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Richard M Watanabe;
Richard M Watanabe
Physiology and Biophysics, University of Southern California Medical School
Los Angeles, California
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Wagdy W Kades;
Wagdy W Kades
Departments of Medicine, University of Southern California Medical School
Los Angeles, California
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Y -D Ida Chen;
Y -D Ida Chen
Department of Medicine, Stanford University Medical School
Stanford, California
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R Evan Sands;
R Evan Sands
The Department of Public Health Sciences, Bowman Gray School of Medicine
Winston-Salem, North Carolina
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Dee Pei;
Dee Pei
Department of Medicine, Stanford University Medical School
Stanford, California
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Peter J Savage;
Peter J Savage
Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, National Institutes of Health
Bethesda, Maryland
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Richard N Bergman
Richard N Bergman
Physiology and Biophysics, University of Southern California Medical School
Los Angeles, California
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Address correspondence and reprint requests to Dr. Mohammed F. Saad, Division of Diabetes, University of Southern California Medical School, 1200 North State Street, Unit I, Room 8250, Los Angeles, CA 90033.
Diabetes 1994;43(9):1114–1121
Article history
Received:
December 06 1993
Revision Received:
May 04 1994
Accepted:
May 04 1994
PubMed:
8070611
Citation
Mohammed F Saad, Randy L Anderson, Ami Laws, Richard M Watanabe, Wagdy W Kades, Y -D Ida Chen, R Evan Sands, Dee Pei, Peter J Savage, Richard N Bergman; A Comparison Between the Minimal Model and the Glucose Clamp in the Assessment of Insulin Sensitivity Across the Spectrum of Glucose Tolerance. Diabetes 1 September 1994; 43 (9): 1114–1121. https://doi.org/10.2337/diab.43.9.1114
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