Title Independent measures of insulin secretion and insulin sensitivity during the same test: the glucagon-insulin tolerance test.
Author/s Mozhgan Dorkhan, Devjit Tripathy, G Malm, H Asgharian, Tiinamaija Tuomi, Leif Groop
Department/s Diabetes and Endocrinology
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Alternative location (URL) http://www.ncbi.nlm.nih.gov/pu... Restricted Access (Alternative Location)
Alternative location (URL) http://dx.doi.org/10.1111/j.13... Restricted Access (Alternative Location)
Publication/Series Journal of internal medicine
Publishing year 2008
Volume 264
Pages 62 - 71
Document type Journal article
Status published
Quality controlled yes
Language English
Abstract English 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.
Subject Medicine and Health Sciences
ISBN/ISSN/Other ISSN: 1365-2796
Part of Assessment and Treatment of Impaired Insulin- Secretion and Action in Type 2 Diabetes

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