Severity Grade Assessment Classifications for Both Insulin Resistance Syndrome and Status of Pancreatic Beta Cell Function in Clinical Practice Using Homeostasis Model Assessment Method Indices

Abstract

Abstract This article aims to classify the severity grading assessments for both insulin resistance (IR) syndrome and status of pancreatic beta (β) islet cells’ function using the homeostasis model assessment method (that is; homeostasis model assessment-insulin resistance [HOMA-IR] and homeostasis model assessment-pancreatic beta (β) islet cells’ function [HOMA-B] indices) with the focus of disseminating this information rapidly for clinical use by physicians in their patients with dysfunctional regulation of glucose metabolism. It will also assist clinicians to prevent and screen for these individuals who are significantly at high risk for insulin resistance (IR) syndrome and impair pancreatic beta (β) islet cells’ function thereby alleviating the risk for associated comorbidities. Insulin resistance (IR) syndrome and pancreatic beta (β) islet cells’ dysfunction with accompanied insufficiency form two major important and crucial factors in the aetiology and pathogenesis of frank type 2 diabetes mellitus (type 2 DM). The pathophysiological process of insulin resistance (IR) syndrome can either be a compensatory or uncompesatory phase response phenomenon, depending on the extent of biochemical response and effect elicited by the pancreatic beta (β) islet cells to secrete insulin. The alteration mechanisms that underlie the pathophysiological processes and biochemical responses that occur during the onset or induction of peripheral IR can be divided into two phases, namely: Euglycaemic hyperinsulinemic phase (compensatory first phase), and Hyperglycaemic hypoinsulinemic phase (uncompensatory second phase). The euglycaemic hyperinsulinemic phase is characterized by relatively normal plasma glucose level with continuous elevated plasma or serum level of insulin release from an intact pancreatic beta (β) islet cell mass in order to compensate and prevent the occurrence of a sustained hyperglycaemic state. The euglycaemic hyperinsulinemic phase of peripheral IR syndrome is said to occur when the fasting plasma/serum insulin assay level is more than or equal to [≥] 25.00 mU/L with a relatively normal value for the fasting plasma glucose level that ranges from 3.60 mmol/L to 5.99 mmol/L. It can also be defined using the three-hour postprandial plasma/serum insulin assay level more than or equal to [≥] 25.00 mU/L with a relatively normal value for the two-hour postprandial plasma glucose level that is less than [