Design and clinical pilot testing of the model-based dynamic insulin sensitivity and secretion test (DISST)

J Diabetes Sci Technol. 2010 Nov 1;4(6):1408-23. doi: 10.1177/193229681000400616.

Abstract

Background: Insulin resistance is a significant risk factor in the pathogenesis of type 2 diabetes. This article presents pilot study results of the dynamic insulin sensitivity and secretion test (DISST), a high-resolution, low-intensity test to diagnose insulin sensitivity (IS) and characterize pancreatic insulin secretion in response to a (small) glucose challenge. This pilot study examines the effect of glucose and insulin dose on the DISST, and tests its repeatability.

Methods: DISST tests were performed on 16 subjects randomly allocated to low (5 g glucose, 0.5 U insulin), medium (10 g glucose, 1 U insulin) and high dose (20 g glucose, 2 U insulin) protocols. Two or three tests were performed on each subject a few days apart.

Results: Average variability in IS between low and medium dose was 10.3% (p=.50) and between medium and high dose 6.0% (p=.87). Geometric mean variability between tests was 6.0% (multiplicative standard deviation (MSD) 4.9%). Geometric mean variability in first phase endogenous insulin response was 6.8% (MSD 2.2%). Results were most consistent in subjects with low IS.

Conclusions: These findings suggest that DISST may be an easily performed dynamic test to quantify IS with high resolution, especially among those with reduced IS.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • Blood Glucose / metabolism*
  • C-Peptide / blood
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Feasibility Studies
  • Female
  • Glucose Tolerance Test*
  • Glucose*
  • Humans
  • Insulin Resistance*
  • Insulin* / blood
  • Male
  • Middle Aged
  • New Zealand
  • Pancreas / metabolism*
  • Pilot Projects
  • Predictive Value of Tests
  • Reproducibility of Results
  • Research Design*
  • Time Factors
  • Young Adult

Substances

  • Biomarkers
  • Blood Glucose
  • C-Peptide
  • Insulin
  • Glucose