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Independent measures of insulin secretion and insulin sensitivity during the same test: the glucagon-insulin tolerance test.

Dorkhan, Mozhgan LU ; Tripathy, Devjit LU ; Malm, G; Asgharian, H; Tuomi, Tiinamaija LU and Groop, Leif LU (2008) In Journal of Internal Medicine 264. p.62-71
Abstract
Background. To validate a test for independent assessment of insulin secretion and insulin sensitivity during the same occasion for metabolic studies in clinical practice, i.e. combined glucagon-stimulated C-peptide test and insulin tolerance test (GITT). Subjects and methods. We measured C-peptide response to 0.5 mg of intravenous glucagon followed 30 min later by administration of 0.05 U kg(-1) insulin (insulin tolerance test, ITT). Ten subjects with normal glucose tolerance participated on different days in an ITT, glucagon-C-peptide test, ITT followed by glucagon-C-peptide test and glucagon-C-peptide test followed by ITT to establish whether and how the tests could be combined. The test was then repeated in nine patients with type 2... (More)
Background. To validate a test for independent assessment of insulin secretion and insulin sensitivity during the same occasion for metabolic studies in clinical practice, i.e. combined glucagon-stimulated C-peptide test and insulin tolerance test (GITT). Subjects and methods. We measured C-peptide response to 0.5 mg of intravenous glucagon followed 30 min later by administration of 0.05 U kg(-1) insulin (insulin tolerance test, ITT). Ten subjects with normal glucose tolerance participated on different days in an ITT, glucagon-C-peptide test, ITT followed by glucagon-C-peptide test and glucagon-C-peptide test followed by ITT to establish whether and how the tests could be combined. The test was then repeated in nine patients with type 2 diabetes to investigate its reproducibility. In 20 subjects with varying degrees of glucose tolerance, the test was compared with the Botnia clamp (an intravenous glucose tolerance test combined with a euglycaemic hyperinsulinemic clamp). Results. When ITT preceded the glucagon test, C-peptide response was blunted. Therefore, we first administered glucagon and then insulin (GITT). The K(ITT) from the GITT was reproducible (CV = 13 %) and correlated strongly with the glucose disposal rate from the Botnia clamp (r = 0.87, r(2) = 0.75, P < 0.001). The C-peptide response to glucagon was reproducible (CV = 13 %). The disposition index, providing a measure of beta-cell function adjusted for insulin sensitivity, calculated from the GITT showed good discrimination between individuals with varying degrees of glucose tolerance. Conclusions. The GITT provides simple, reproducible and independent estimates of insulin sensitivity and secretion on the same occasion for metabolic studies in individuals with normal and abnormal glucose tolerance. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Internal Medicine
volume
264
pages
62 - 71
publisher
Wiley-Blackwell
external identifiers
  • PMID:18298489
  • WOS:000256619200007
  • Scopus:44949174021
ISSN
1365-2796
DOI
10.1111/j.1365-2796.2008.01921.x
language
English
LU publication?
yes
id
22d20f8e-a608-4a48-9fff-fe30b47e3ffd (old id 1041552)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18298489?dopt=Abstract
date added to LUP
2008-03-04 09:14:53
date last changed
2016-10-13 04:31:39
@misc{22d20f8e-a608-4a48-9fff-fe30b47e3ffd,
  abstract     = {Background. To validate a test for independent assessment of insulin secretion and insulin sensitivity during the same occasion for metabolic studies in clinical practice, i.e. combined glucagon-stimulated C-peptide test and insulin tolerance test (GITT). Subjects and methods. We measured C-peptide response to 0.5 mg of intravenous glucagon followed 30 min later by administration of 0.05 U kg(-1) insulin (insulin tolerance test, ITT). Ten subjects with normal glucose tolerance participated on different days in an ITT, glucagon-C-peptide test, ITT followed by glucagon-C-peptide test and glucagon-C-peptide test followed by ITT to establish whether and how the tests could be combined. The test was then repeated in nine patients with type 2 diabetes to investigate its reproducibility. In 20 subjects with varying degrees of glucose tolerance, the test was compared with the Botnia clamp (an intravenous glucose tolerance test combined with a euglycaemic hyperinsulinemic clamp). Results. When ITT preceded the glucagon test, C-peptide response was blunted. Therefore, we first administered glucagon and then insulin (GITT). The K(ITT) from the GITT was reproducible (CV = 13 %) and correlated strongly with the glucose disposal rate from the Botnia clamp (r = 0.87, r(2) = 0.75, P &lt; 0.001). The C-peptide response to glucagon was reproducible (CV = 13 %). The disposition index, providing a measure of beta-cell function adjusted for insulin sensitivity, calculated from the GITT showed good discrimination between individuals with varying degrees of glucose tolerance. Conclusions. The GITT provides simple, reproducible and independent estimates of insulin sensitivity and secretion on the same occasion for metabolic studies in individuals with normal and abnormal glucose tolerance.},
  author       = {Dorkhan, Mozhgan and Tripathy, Devjit and Malm, G and Asgharian, H and Tuomi, Tiinamaija and Groop, Leif},
  issn         = {1365-2796},
  language     = {eng},
  pages        = {62--71},
  publisher    = {ARRAY(0x98045b8)},
  series       = {Journal of Internal Medicine},
  title        = {Independent measures of insulin secretion and insulin sensitivity during the same test: the glucagon-insulin tolerance test.},
  url          = {http://dx.doi.org/10.1111/j.1365-2796.2008.01921.x},
  volume       = {264},
  year         = {2008},
}