COMPARISON OF THE MINIMAL MODEL AND THE HYPERGLYCEMIC CLAMP FOR MEASURING INSULIN SENSITIVITY AND ACUTE INSULIN-RESPONSE TO GLUCOSE

Glucose clamp techniques are established methods for assessment of ins ulin sensitivity and secretion. The minimal model technique (MMT) has been proposed as an alternative approach to the hyperinsulinemic-eugly cemic clamp technique for determination of an insulin sensitivity inde x (ISI), but has not been directly compared with the hyperglycemic cla mp for measurement of ISI or insulin secretion. To address this issue, the present study was undertaken to compare determinations of ISI and the acute insulin response to glucose (AIRS) obtained using the MMT w ith similar measures obtained from a hyperglycemic clamp. Measures for ISI and AIRS obtained from MMT analysis of a tolbutamide-modified fre quently sampled intravenous glucose tolerance test (FSIGT) were compar ed with similar measures obtained from a 3-hour hyperglycemic clamp pe rformed at a plasma glucose level of 10 mmol/L(180 mg/dL), Paired comp arisons were performed in 14 women with normal glucose tolerance. Sign ificant positive correlation coefficients were obtained for both ISI ( r = .88, P < .001) and AIRS (r = .75, P < .005) between the MMT and cl amp studies, We conclude that indices for ISI and AIRS obtained with t he MMT are highly correlated with those obtained using the hyperglycem ic clamp. The MMT is a valid alternative to the hyperglycemic clamp fo r assessing insulin sensitivity and AIRS. Copyright (C) 1995 by W.B. S aunders Company