Assessment of methods and indexes of insulin sensitivity
abstract
Insulin resistance contributes to the pathophysiology of diabetes and is a hallmark of obesity, metabolic
syndrome, and many cardiovascular diseases. Therefore, quantifying insulin sensitivity/resistance in
humans and animal models is of great importance.
Various methods are used to assess insulin sensitivity both in individuals and in study populations.
Validity, reproducibility, cost, and degree of subject burden are important factors for both clinicians and
researchers to consider when weighing the merits of a particular method. Some methods rely on steadystate
analysis of glucose and insulin, whereas others rely on dynamic testing. Each of these methods has
distinct advantages and limitations. Thus, optimal choice and employment of a specific method depend
on the nature of the studies being performed. Established direct methods for measuring insulin sensitivity
in vivo are relatively complex. Finally, simple surrogate indexes for insulin sensitivity/resistance
are available that are derived from blood insulin and glucose concentrations under fasting conditions
(steady state) or in the postprandial state (dynamic). This article highlight merits, limitations, and appropriate
use of current in vivo measures of insulin sensitivity/resistance and presents the advantages and
disadvantages of each.
Keywords:
Hyperinsulinemic Euglycemic Glucose
Clamp
Oral Glucose Tolerance Test
Meal Tolerance Test
Rapid Insulin Sensitivity Test
Homeostasis Model Assessment
Oral Glucose Insulin Sensitivity