Simple Self-Administered Method for Assessing Insulin Sensitivity in Diabetic Patients

Abstract

Several methods have been proposed for evaluating a person’s insulin sensitivity from an oral glucose tolerance test (OGTT) and the euglycemic insulin clamp technique. However, none are easy or inexpensive to implement since the plasma insulin concentration, a key variable for assessing the insulin sensitivity index (ISI), is required to be clinically measured at specific times. Therefore, the purpose of this study is to develop a new ISI that can be easily and accurately obtained by patients themselves without costly, time-consuming, and inconvenient testing methods. This study proposes a simple self-administered testing method, simulated on a computerized model of type II diabetic patients, for estimating the ISI. The test involves a 75-g glucose ingestion and two injections of 10 mU/kg insulin. Blood glucose is measured 1 and 2 h later. The test was evaluated by using a previously developed diabetic-patient dynamic model. Fifteen sets of OGTT data from diabetic patients published in the literature were used for the model development. A simulation of the proposed self-administered test indicates that the proposed ISI correlates well with the ISI called M-value obtained from the gold standard but elaborate euglycemic hyperinsulinemic clamp (r = 0.927, p = 0.0045). The proposed ISI is considered to be easy to perform, time-saving, inexpensive, and accurate enough for clinical assessments.