A highly correlated method to assess insulin resistance in broad populations
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A HIGHLY CORRELATED METHOD TO ASSESS INSULIN RESISTANCE IN BROAD POPULATIONS PowerPoint PPT Presentation


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A HIGHLY CORRELATED METHOD TO ASSESS INSULIN RESISTANCE IN BROAD POPULATIONS. T Lotz 1 J G Chase 1 , KA McAuley 2 , GM Shaw 3 , CE Hann 1 , JI Mann 2 1 Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand

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A HIGHLY CORRELATED METHOD TO ASSESS INSULIN RESISTANCE IN BROAD POPULATIONS

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A highly correlated method to assess insulin resistance in broad populations

A HIGHLY CORRELATED METHOD TO ASSESS INSULIN RESISTANCEIN BROAD POPULATIONS

T Lotz1

J G Chase1, KA McAuley2, GM Shaw3, CE Hann1, JI Mann2

1Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand

2Edgar National Centre for Diabetes Research, University of Otago, Dunedin, New Zealand

3Department of Intensive Medicine, Christchurch Hospital, Christchurch, New Zealand


The problem

The Problem

  • Insulin resistance is a major risk factor in the development of type-2 Diabetes and cardiovascular disease

  • Early and regular monitoring is crucial to assess effects of intervention

  • Accurate assessment is difficult and stressful with current methods


Current methods

CLAMP

3-6 hours

IVGTT

2-4 hours

STRESS + LENGTH + COST

GOAL FOR NEW TEST

HOMA

10 mins

ACCURACY

Current methods

Can we be accurate, yet simple and short??


Concept

glucose

Glucose profile

0

5

10

15

20

25

30

Concept

  • Short, simple, no steady state necessary (30-60 min)

  • Physiological doses of glucose+insulin

  • Measure glucose, insulin, C-peptide

  • Fit model to data

  • Determine SI from model

  • Physiological model necessary!

Glucose

Insulin


Model of glucose and insulin kinetics

uex

PANCREAS

nI

PLASMA

INTERSTITIAL

FLUID

uen

CELLS

nC

diffusion

nK

nL

KIDNEYS

LIVER

Model of Glucose and Insulin Kinetics

GLUCOSE

(Lotz et al ICBME 2005)


Model validation on gold standard clamp test

Model validation on ‘gold-standard’ clamp test

  • High correlations at steady and transient states

steady

transient

r=0.98


Test simulation

Test simulation

  • Simulated population from clamp data (N=195)

  • Correlation r=0.93 between model SI and clamp ISI during 40 minute transient test

  • Model captures dynamics of insulin and glucose within measurement error

  • Low, physiological dosing

    • Increased safety and accuracy


Conclusions

Conclusions

  • Simple model-based dose response test to assess insulin resistance

  • Physiological dosing, short duration, cost efficient, yet highly accurate!

  • Simulation results correlate r=0.93 with ‘gold standard’ clamp test

  • Potential for application in a clinical setting


Acknowledgements questions

Acknowledgements – Questions?

Jessica Lin

Jason Wong

Chris Hann

Geoff Chase

Geoff Shaw

Dominic Lee

Kirsten McAuley

Jim Mann

Steen Andreassen


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