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Usefulness of the insulin tolerance test in patients with type 2 diabetes receiving insulin therapy.

Okita K, Iwahashi H, Kozawa J, Okauchi Y, Funahashi T, Imagawa A, Shimomura I - J Diabetes Investig (2013)

Bottom Line: To establish the validity of the plasma glucose disappearance rate (KITT), derived from an insulin-tolerance test (ITT), for evaluating the insulin sensitivity of patients with type 2 diabetes after insulin therapy.In study 1, a close correlation between KITT and the average glucose infusion rate during the last 30 min of the standard clamp-IR test (M-value) was noted (P < 0.001).High-density lipoprotein cholesterol (P = 0.0183), low-density lipoprotein cholesterol (P = 0.0121) and adiponectin (P = 0.0384) levels were positively correlated with the log-transformed KITT.

View Article: PubMed Central - PubMed

Affiliation: Department of Metabolic Medicine Graduate School of Medicine Osaka University Suita City Osaka Japan.

ABSTRACT

Aims/introduction: To establish the validity of the plasma glucose disappearance rate (KITT), derived from an insulin-tolerance test (ITT), for evaluating the insulin sensitivity of patients with type 2 diabetes after insulin therapy.

Materials and methods: In the first arm of the study, 19 patients with poorly controlled diabetes were treated with insulin and underwent an ITT and a euglycemic clamp test (clamp-IR). The relationship between the insulin resistance index, as assessed by both the clamp-IR and KITT tests, was examined. In the second arm of the study, the relationships between KITT values and various clinical parameters were investigated in 135 patients with poorly controlled diabetes, after achieving glycemic control with insulin.

Results: In study 1, a close correlation between KITT and the average glucose infusion rate during the last 30 min of the standard clamp-IR test (M-value) was noted (P < 0.001). In study 2, body mass index (P = 0.0011), waist circumference (P = 0.0004), visceral fat area (P = 0.0011) and the log-transformed homeostasis model assessment of insulin resistance value (P = 0.0003) were negatively correlated with the log-transformed KITT. High-density lipoprotein cholesterol (P = 0.0183), low-density lipoprotein cholesterol (P = 0.0121) and adiponectin (P = 0.0384) levels were positively correlated with the log-transformed KITT.

Conclusions: The ITT is a valid and useful test for evaluating the insulin sensitivity of patients with diabetes, even after treatment with insulin.

No MeSH data available.


Related in: MedlinePlus

Relationship between insulin sensitivity, measured by the plasma glucose disappearance rate (KITT), and various clinical parameters in study 2.
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jdi12143-fig-0003: Relationship between insulin sensitivity, measured by the plasma glucose disappearance rate (KITT), and various clinical parameters in study 2.

Mentions: After treatment, the mean FPG of the 123 patients improved from 178.3 ± 46.8 to 114.9 ± 18.4 mg/dL. The insulin dose used for glycemic control was 22.0 ± 11.7 U/day; NPH insulin was used in 59 patients for glycemic control, with sulfonylurea being substituted for NPH insulin during the night before the ITT. The post‐treatment KITT was 1.77 ± 1.14%/min (range 0.39–6.16%/min). The body mass index (r = −0.279, P = 0.0011), waist circumference (r = −0.318, P = 0.0004), visceral fat area (r = −0.345, P = 0.0011) and log‐transformed HOMA‐IR (r = −0.307, P = 0.0003) were all negatively correlated with log‐tranformed KITT; levels of HDL‐C (r = 0.204, P = 0.0183), LDL‐C (r = 0.216, P = 0.0121) and adiponectin (r = 0.206, P = 0.0384) were positively correlated with log‐tranformed KITT (Table 3; Figure 3). A significant correlation was not observed between KITT and HbA1c, blood pressure, triglyceride level or insulin secretion capacity.


Usefulness of the insulin tolerance test in patients with type 2 diabetes receiving insulin therapy.

Okita K, Iwahashi H, Kozawa J, Okauchi Y, Funahashi T, Imagawa A, Shimomura I - J Diabetes Investig (2013)

Relationship between insulin sensitivity, measured by the plasma glucose disappearance rate (KITT), and various clinical parameters in study 2.
© Copyright Policy - creativeCommonsBy-nc-nd
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4020335&req=5

jdi12143-fig-0003: Relationship between insulin sensitivity, measured by the plasma glucose disappearance rate (KITT), and various clinical parameters in study 2.
Mentions: After treatment, the mean FPG of the 123 patients improved from 178.3 ± 46.8 to 114.9 ± 18.4 mg/dL. The insulin dose used for glycemic control was 22.0 ± 11.7 U/day; NPH insulin was used in 59 patients for glycemic control, with sulfonylurea being substituted for NPH insulin during the night before the ITT. The post‐treatment KITT was 1.77 ± 1.14%/min (range 0.39–6.16%/min). The body mass index (r = −0.279, P = 0.0011), waist circumference (r = −0.318, P = 0.0004), visceral fat area (r = −0.345, P = 0.0011) and log‐transformed HOMA‐IR (r = −0.307, P = 0.0003) were all negatively correlated with log‐tranformed KITT; levels of HDL‐C (r = 0.204, P = 0.0183), LDL‐C (r = 0.216, P = 0.0121) and adiponectin (r = 0.206, P = 0.0384) were positively correlated with log‐tranformed KITT (Table 3; Figure 3). A significant correlation was not observed between KITT and HbA1c, blood pressure, triglyceride level or insulin secretion capacity.

Bottom Line: To establish the validity of the plasma glucose disappearance rate (KITT), derived from an insulin-tolerance test (ITT), for evaluating the insulin sensitivity of patients with type 2 diabetes after insulin therapy.In study 1, a close correlation between KITT and the average glucose infusion rate during the last 30 min of the standard clamp-IR test (M-value) was noted (P < 0.001).High-density lipoprotein cholesterol (P = 0.0183), low-density lipoprotein cholesterol (P = 0.0121) and adiponectin (P = 0.0384) levels were positively correlated with the log-transformed KITT.

View Article: PubMed Central - PubMed

Affiliation: Department of Metabolic Medicine Graduate School of Medicine Osaka University Suita City Osaka Japan.

ABSTRACT

Aims/introduction: To establish the validity of the plasma glucose disappearance rate (KITT), derived from an insulin-tolerance test (ITT), for evaluating the insulin sensitivity of patients with type 2 diabetes after insulin therapy.

Materials and methods: In the first arm of the study, 19 patients with poorly controlled diabetes were treated with insulin and underwent an ITT and a euglycemic clamp test (clamp-IR). The relationship between the insulin resistance index, as assessed by both the clamp-IR and KITT tests, was examined. In the second arm of the study, the relationships between KITT values and various clinical parameters were investigated in 135 patients with poorly controlled diabetes, after achieving glycemic control with insulin.

Results: In study 1, a close correlation between KITT and the average glucose infusion rate during the last 30 min of the standard clamp-IR test (M-value) was noted (P < 0.001). In study 2, body mass index (P = 0.0011), waist circumference (P = 0.0004), visceral fat area (P = 0.0011) and the log-transformed homeostasis model assessment of insulin resistance value (P = 0.0003) were negatively correlated with the log-transformed KITT. High-density lipoprotein cholesterol (P = 0.0183), low-density lipoprotein cholesterol (P = 0.0121) and adiponectin (P = 0.0384) levels were positively correlated with the log-transformed KITT.

Conclusions: The ITT is a valid and useful test for evaluating the insulin sensitivity of patients with diabetes, even after treatment with insulin.

No MeSH data available.


Related in: MedlinePlus