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A HIGHLY CORRELATED METHOD TO ASSESS INSULIN RESISTANCE IN BROAD POPULATIONS

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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  1. 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

  2. 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

  3. 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??

  4. 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

  5. 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)

  6. Model validation on ‘gold-standard’ clamp test • High correlations at steady and transient states steady transient r=0.98

  7. 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

  8. 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

  9. Acknowledgements – Questions? Jessica Lin Jason Wong Chris Hann Geoff Chase Geoff Shaw Dominic Lee Kirsten McAuley Jim Mann Steen Andreassen

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