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Inherited Susceptibility to Metabolic Complications of Obesity
Published in Claude Bouchard, The Genetics of Obesity, 2020
Roger R. Williams, Paul N. Hopkins, Steven C. Hunt, M. Catherine Schumacher, Barry M. Stults, Lily L. Wu, Sandra J. Hasstedt
Insulin resistance is defined as decreased insulin-mediated rates of whole-body glucose uptake. It can be measured using a combination of the insulin/glucose clamp technique and tracer glucose infusion with indirect calorimetry.1 The two components of whole-body glucose uptake include glucose oxidation and nonoxidative glucose disposal (glycogen synthesis). Even in healthy persons there is a considerable variation in insulin sensitivity by age and even greater variability between individuals within a given age group. In a study of 124 healthy, normal-weight subjects (ages 19 to 76), mean insulin-mediated glucose disposal decreased by about 40% from the young adults in their mid-20s to older adults in their mid-60s. Within the youngest group of adults, the most insulin-sensitive individual used glucose at a rate four times that of the most insulin-resistant person.
General Nutritional Considerations for Chronic Hyperglycemia—Type 2 Diabetes
Published in Robert Fried, Richard M. Carlton, Type 2 Diabetes, 2018
Robert Fried, Richard M. Carlton
The glucose clamp technique measures how well an individual metabolizes glucose or how sensitive an individual is to insulin (von Wartburg. 2007). The hyperglycemic clamp consists of quickly raising plasma glucose concentration to 125 mg/dL above basal levels by a continuous infusion of glucose. This hyperglycemic plateau is maintained by adjustment of a variable glucose infusion, based on the rate of insulin secretion and glucose metabolism.
The Neonatal STZ Model of Diabetes
Published in John H. McNeill, Experimental Models of Diabetes, 2018
Stephen W. Schaffer, Mahmood Mozaffari
The insulin glucose clamp technique has commonly been used to evaluate insulin action in vivo. Based on this technique, Blondel et al.23 found that whole-body glucose utilization was normal in the 10-week-old n2 STZ Wistar female rat, but was significantly reduced in the severely diabetic n5 STZ female Wistar rat. They also found that the n5 STZ, but not the n0 STZ rat, exhibited reduced suppression of hepatic glucose production by insulin. Somewhat unexpected was an observation made by the same group38 that the n0 STZ rat exhibited a significant elevation in insulin sensitivity. Although the basis underlying this link between hypoinsulinemia and increased insulin sensitivity in the young, n0 STZ rat has not been established, alterations in insulin receptor function appear to have been ruled out as a cause.39 A likely scenario is that an early step in the signal transduction pathway of insulin becomes defective, causing increased insulin sensitivity of several events, including glycogenesis, lipogenesis, glucose production, amino acid transport, and glucose oxidation.38,39
Practical aspects of insulin administration: what the healthcare provider knows
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2022
Nousheen Parker, Ankia Coetzee, Lourentia van Wyk, Magda Conradie
In our study, HCPs notably lacked knowledge regarding simple aspects such as insulin administration, re-suspension and priming of the insulin pen. These, per se, may have a major impact on the day-to-day glycaemic control in PLWD, without incurring any additional cost. In our study, only a quarter of participants knew how to re-suspend cloudy insulin. The most recent East Africa Diabetes Study Group guidelines19 acknowledge that without this crucial step there is no control over the dose injected. A study by Kaiser et al. showed that the actual dose injected may vary between 25% and 200% of the intended dose if NPH is only re-suspended three times instead of 20 times.20 This large variation in dose accuracy was also confirmed by a randomised, crossover study that used the euglycemic glucose clamp technique.21
Relationships among pancreatic beta cell function, the Nrf2 pathway, and IRS2: a cross-sectional study
Published in Postgraduate Medicine, 2020
Yiying Liu, Yue Zeng, Ying Miao, Xiaoling Cheng, Sijie Deng, Xinlin Hao, Yuefei Jiang, Qin Wan
The accurate assessment of islet β-cell function is necessary for the treatment of patients with diabetes. The glucose clamp technique, which is the preferred clinical evaluation method, is one of the most sensitive methods for the determination of increased insulin secretion based on pulses; however, owing to the elaborate operational requirements and the equipment costs, it is suitable only for studies with a small sample size. Since the sample size in this study was larger and included the glucose metabolism group, we selected OGTT in combination with the measurement of fasting insulin levels and the ISI method for the comprehensive assessment of individual islet β-cell function [19].
Assessment of insulin resistance and metabolic syndrome in young reproductive aged women with polycystic ovarian syndrome: analogy of surrogate indices
Published in Archives of Physiology and Biochemistry, 2022
Nadia Rashid, Aruna Nigam, Sana Kauser, Prem Prakash, S. K. Jain, Saima Wajid
Insulin resistance is considered as an independent risk factor for cardiovascular disease and is a common feature in women with PCOS. Therefore, early recognition of insulin resistant phenotype is necessary for the prevention of cardiovascular disease in young women with PCOS. Though the gold standard to assess insulin resistance is hyperinsulinemic-euglycemic clamp (glucose clamp) technique, it is not convenient and cost effective technique for epidemiological studies. Various other surrogate markers like HOMA-IR, LAP, and TG/HDL are being used to assess insulin resistance.