Objective this study was designed to determine a cutoff point for identifying insulin resistance from hyperinsulinemiceuglycemic clamp studies performed at 120 mum2. The hyperinsulinemic euglycemic clamp, or insulin clamp, is widely considered the. Caffeine ingestion decreases glucose disposal during a hyperinsulinemic euglycemic clamp in sedentary humans felicia greer,1 robert hudson,2 robert ross,3 and terry graham4 the purpose of this investigation was to examine the effect of caffeine an adenosine receptor antagonist on wholebody insulinmediated glucose disposal in resting humans. The hyperinsulinemic euglycemic clamp is the gold standard for assessment of insulin resistance and requires frequent, accurate measurements of blood glucose concentrations, typically utilizing the ysi 2300 stat plus glucose analyzer ysi, inc. The plasma glucose concentration is acutely raised to 125 mgdl above basal levels by a priming infusion of glucose. Intravenous bolus of regular insulin at a dose of 1 unitkg.
During an insulin clamp, hyperinsulinemia is achieved. In clinical research, a hyperinsulinemic euglycemic clamp is considered the gold standard to evaluate insulin sensitivity, however there is no agreement on the duration of a clamp as they can range from 28 hours. Multiyear reproducibility of hyperinsulinemic euglycemic. The primary objective of this study was to evaluate insulin sensitivity in healthy subjects treated with olanzapine or risperidone. The hyperinsulinemiceuglycemic clamp in the conscious mouse. Hyperinsulinemic euglycemic insulin sensitivity clamp prosciento. This technique has been applied to several species including humans, dogs, rats and mice.
The hyperinsulinemic euglycemic clamp study, which was carried out after an overnight 12 to 14 h fast, consisted of 2 h of euglycemic insulin infusion at a rate of 40 mumin per meter squared of body surface area, and was preceded by a 2h control period as previously described defronzo et al. Modeling the euglycemic hyperinsulinemic clamp by stochastic. Hyperinsulinemiceuglycemic clamp examination insulin sensitivity was evaluated by a hyperinsulinemiceuglycemic clamp examination using an arti. Original article vanderbilt university medical center. Publication hyperinsulinemiceuglycemic clamps in conscious. Pdf defining insulin resistance from hyperinsulinemic. Horses will be administered an intravenous bolus of insulin 45 milli iu per killogram body weight followed by an infusion of insulin 6 milli iu per killogram body weight and 50% dextrose to achieve a steady state euglycemic hyperinsulinemia for 60 hours or until obel grade 3 laminitis is achieved, whichever. Correlation of glucose disposal rate by euglycemic.
The hyperinsulinemic euglycemic clamp, or insulin clamp, is widely considered the gold standard method for assessing insulin action in vivo. Insulin resistance and compensatory hyperinsulinemia are risk factors of type 2 diabetes mellitus 1. The hyperinsulinemic euglycemic clamp hec is the gold standard for measuring insulin sensitivity, but glycemic recovery and stabilization after the procedure have not been well studied. Of these, hyperinsulinemic euglycemic clamp is the goldstandard method to assess insulin sensitivity. Hyperinsulinemiceuglycemic clamp technique an overview. Evaluation of insulin sensitivity in healthy volunteers. Hyperinsulinemia euglycemia therapy hiet initiation. Euglycemic hyperinsulinemic clamp and hyperglycemic. Following the basal period, a 2hr hyperinsulinemic euglycemic clamp will be conducted with a primed 150 mukg body weight and continuous infusion of human insulin at a rate of 15 pmolkgmin to raise plasma insulin within a physiological range. Hyperinsulinemia euglycemia therapy hiet for beta blocker.
This study was designed to determine a cutoff point for identifying insulin resistance from hyperinsulinemiceuglycemic clamp studies performed at 120 mum2min in a white population and to. We performed hyperinsulinemic 300 xumleuglycemic glucose clamps for 180 min in normal dogs and compared the standard approach, an. Insulin was given as intravenous loading doses starting from 4. The statstrip glucose monitor is suitable for use during. The hyperinsulinemiceuglycemic clamp, or insulin clamp, is widely considered the gold standard method for assessing insulin action in vivo. We have previously found that a hyperinsulinemiceuglycemic clamp hec attenuates plasma concentrations of tumor necrosis factor. Here, we assessed the physiological determinants of postclamp recovery. The euglycemic clamp is widely used in clinics and laboratories to measure insulin action on glucose utilization in humans and animals for clinical and basic science research. Apr 17, 2018 for many years, the hyperinsulinemiceuglycemic clamp has been used as a gold standard method to accurately measure insulin action in vivo 2. The hyperinsulinemic clamp is also called euglycemic clamp, meaning a normal blood sugar level is maintained.
Objective with increasing emphasis on the recognition of the metabolic syndrome and early type 2 diabetes, a clinically useful measure of insulin resistance is desirable. Characterized by either inadequate insulin production or the inability to utilize insulin. The hyperinsulinemic euglycemic clamp study, which was carried out after an. The hyperinsulinemic, euglycemic clamp or insulin clamp has been used in a. During an insulin clamp, hyperinsulinemia is achieved by a constant insulin infusion. Evaluation of insulin sensitivity by hyperinsulinemic. Hypoglycemic clamps have been extensively used in studies of the pathophysiology of iatrogenic hypoglycemia.
Project methods laminitis will be induced via euglycemic hyperinsulinemic clamp. Insulinmediated glucose disposal, assessed with the hyperinsulinemic euglycemic clamp, is reproducible in healthy african americans and european americans. Caffeine ingestion decreases glucose disposal during a. Hyperinsulinemic euglycemic insulin sensitivity clamp. Effects of pentoxifylline on hyperinsulinemic laminitis in. Nov 16, 2011 the hyperinsulinemic euglycemic clamp, or insulin clamp, is widely considered the gold standard method for assessing insulin action in vivo. Original article considerations in the design of hyperinsulinemic euglycemic clamps in the conscious mouse julio e. The purpose of this study was to evaluate whether an index of glucose metabolism, as measured by co2 generation from ingested cglucose, would correlate with indexes from the hyperinsulinemiceuglycemic clamp. Listing a study does not mean it has been evaluated by the u. Prior studies show a varied and limited correlation of these methods with ehc.
Indirect but more feasible methods of determining insulin sensitivity often use glucose and insulin data obtained at fasting andor after a glucose load. Considerations in the design of hyperinsulinemiceuglycemic. The hyperinsulinemic hypoglycemic clamp is a variant of the glucose clamp technique designed to assess counterregulatory hormone responses under standardized conditions of experimental hypoglycemia. The euglycemic hyperinsulinemic clamp ehc is the most widely used experimental procedure for the determination of insulin sensitivity. Hyperinsulinemiceuglycemic clamp in the conscious rat protocol. Assessment of insulin sensitivity by the hyperinsulinemic. Homeostatic tests based on fasting glucose and insulin homa, quicki, glucoseinsulin ratio gi are estimates of the ehc. Short report open access undercarboxylated osteocalcin.
The most widely used dynamic method is the euglycemic hyperinsulinemic clamp technique, which is generally considered to be the gold standard for measuring insulin sensitivity in vivo. Objective this study was designed to determine a cutoff point for identifying insulin resistance from hyperinsulinemiceuglycemic clamp studies performed at 120 mum2min in a white population and to generate equations from routinely measured clinic and blood variables for predicting clampderived glucose disposal rate gdr, i. Subjects were randomly assigned to singleblind therapy with olanzapine 10 mgd, risperidone 4 mgd, or placebo for approximately 3 wk. Hyperinsulinemic euglycemic clamp protocol the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Methods for the quantification of betacell sensitivity to glucose hyperglycemic clamp technique and of tissue sensitivity to insulin euglycemic insulin clamp technique are described.
Assessment of insulin sensitivity by the hyperinsulinemic euglycemic. Repeatability and reproducibility of the hyperinsulinemiceuglycemic. The most widely used method is the euglycemic hyperinsulinemic clamp technique, which is generally considered to be the gold standard for measuring insulin sensitivity in vivo defronzo et al. The plasma glucose concentration is acutely raised to 125 mgdl above basal levels by a continuous infusion of glucose. Hyperinsulinemic euglycemic insulin sensitivity clamp example data subjects with type 2 diabetes n15 during second step of clamp at steady state. Pdf this study was designed to determine a cutoff point for identifying insulin resistance from hyperinsulinemiceuglycemic clamp studies performed at. Pdf type 2 diabetes t2d is rapidly rising in prevalence. Estimation of endogenous glucose production during. Methods a total of 129 subjects were selected from participants admitted our diabetes center at osaka city university hospital. Wasserman despite increased use of the hyperinsulinemic euglycemic clamp to study insulin action in mice, the effects of exper.
After an overnight fast, subjects were admitted to the clinical investigation unit of the university of alberta hospital, where intravenous catheters were placed in both arms for insulin and glucose infusion and. Correlation of body musclefat ratio with insulin sensitivity. Hyperinsulinemiceuglycemic clamps in conscious, unrestrained. Physiology of glycemic recovery and stabilization after.
Hyperinsulinemiceuglycemic clamp to assess insulin. A novel index to identify steadystate glucose infusion rates. Pdf type 2 diabetes is characterized by a defect in insulin action. Impact of experimental variables despite increased use of the h despite increased use of the hyperinsulinemic euglycemic clamp to study insulin action in mice, there has been no attention to the effect of experimental parameters. In the hyperinsulinemiceuglycemic clamp tech nique, a steadystate.
Hyperinsulinemic euglycemic clamp protocol full text view. Pdf hyperinsulinemiceuglycemic clamps in conscious. The hyperinsulinemic euglycemic clamp was carried out as described in a similar comparative study. Insulin sensitivity was assessed pre and posttreatment using a 2step, hyperinsulinemic, euglycemic clamp. Standard operating procedures for describing and performing. Evaluation of insulin sensitivity by hyperinsulinemiceuglycemic. The gold standard for investigating and quantifying insulin resistance is the hyperinsulinemic euglycemic clamp, socalled because it measures the amount of glucose necessary to compensate for an increased insulin level without causing hypoglycemia. Pdf hyperinsulinemiceuglycemic clamp in the conscious rat. The outcome measure of this method is the glucose infusion rate gir. Manual feedback technique for the control of blood. The hyperinsulinemic euglycemic clamp, used primarily to assess. The hyperinsulinemic euglycemic clamp in the conscious mouse.
Defining insulin resistance from hyperinsulinemiceuglycemic. Insulin is infused at a constant rate stimulating glucose uptake. Despite increased use of the hyperinsulinemic euglycemic clamp to study insulin action in mice, the effects of experimental parameters on the results obtained have not been addressed. With this technique, a primedcontinuous infusion of insulin is administered to raise the plasma insulin concentration to a. The amount of exogenous glucose infused to counter this drop is indicative of insulin sensitivity. Despite increased use of the hyperinsulinemiceuglycemic clamp to study insulin action in mice, the effects of experimental parameters on the results obtained have not been addressed. The hyperinsulinemic euglycemic clamp using radiolabeled tracers is a unique solution for distinguishing your compound from your competitors products. The hyperinsulinemiceuglycemic clamp, or insulin clamp, is the gold standard for assessing insulin action in.
Euglycemic hyperinsulinemic clamp ehc is the ldquogold standardrdquo for assessment of ir, but it is not suitable in a clinical setting. In the present study, sixteen subjects with bmi between 18. Evaluation of insulin sensitivity by hyperinsulinemiceuglycemic clamps using stable isotopelabeled glucose. Carotid artery and jugular vein catheters were implanted. The hyperinsulinemiceuglycemic he clamp procedure is. The hyperinsulinemic euglycemic clamp is the gold standard for the assessment of insulin action.
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