Method of Insulin Administration Has No Effect on Insulin Sensitivity Estimates From the Insulin-Modified Minimal Model Protocol

The effect of the method of insulin administration on insulin sensitivity estimates from the insulin modified minimal model (MINMOD) protocol was evaluated using the tolbutamide-boosted protocol as a reference. The study included 21 nondiabetic men ages 40 ± 2 years (mean ± SE) with a BMI of 26.6 ± 1.1 kg/m². Each subject underwent four frequently sampled intravenous glucose tolerance tests (FSIGTT), one with tolbutamide and three with the same insulin dosage (0.03 U/kg) given as a bolus or infusion over 5 or 10 min. The insulin sensitivity index (S_I) of each subject was calculated from each FSIGTT with MINMOD. Insulin sensitivity indexes from the four FSIGTTs were highly correlated (r > 0.85, P < 0.001). S_I(insulin) from the bolus and the 5- and 10-min infusion protocols were similar, but were 21 ± 5, 29 ± 5, and 23 ± 4% lower than S_{I(tolbntamde)}, respectively. S_{G(tolbutamide)} and S_G(insulin) were not different among the four protocols and were significantly correlated (r > 0.55, P < 0.01). Thus the tolbutamide and insulin protocols must not be used interchangeably in any single cross-sectional or longitudinal study. When the same insulin dosage is used, the method of its administration has no bearing on insulin sensitivity estimates from the insulin-modified FSIGTT. The same method of insulin administration should be used, however, in any single study for purpose of standardization.