Rani Komal, Patil Parag, Bharti Prahalad, Kumar Saroj, Prabhala Shailaja
Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India.
Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India.
Horm Mol Biol Clin Investig. 2024 Aug 8. doi: 10.1515/hmbci-2023-0061.
Type 2 diabetes, obesity, and several other metabolic diseases are all largely attributed to the problem known as insulin resistance. Diagnosing insulin resistance promptly and accurately is essential for adequately managing and intervening in metabolic disorders. Several diagnostic methods have been developed to assess insulin resistance. However, each method has advantages and disadvantages. The most precise test is the hyperinsulinemic-euglycemic clamp, which examines the direct impact of insulin on glucose uptake by tissues. However, it is primarily utilized in research due to its complexity and intrusiveness. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and the Quantitative Insulin Sensitivity Check Index (QUICKI) are the second most used Insulin resistance tests in the clinical setup. These tests are based on measuring the fasting glucose and insulin levels. The Oral Glucose Tolerance Test (OGTT), Insulin tolerance test, and the Matsuda Index are further diagnostic procedures that shed light on insulin sensitivity. The improved techniques, such as the insulin suppression test and the minimal model analysis, provide substitutes for unique clinical circumstances. Additionally, including extra measurements with these tests, like waist circumference, lipid profiles, and inflammatory markers, can improve the evaluation of insulin resistance. In summary, identifying insulin resistance is essential for the early detection and treatment of various metabolic illnesses. To make educated judgments and improve patient care, healthcare workers should be aware of the different available diagnostic tests and how they are used in each situation. Insulin resistance detection and monitoring will require further study to improve current diagnostic approaches and create novel, less invasive techniques.
2型糖尿病、肥胖症以及其他几种代谢性疾病在很大程度上都归因于胰岛素抵抗这一问题。及时、准确地诊断胰岛素抵抗对于充分管理和干预代谢紊乱至关重要。已经开发了几种诊断方法来评估胰岛素抵抗。然而，每种方法都有其优缺点。最精确的测试是高胰岛素-正葡萄糖钳夹技术，它检测胰岛素对组织摄取葡萄糖的直接影响。然而，由于其复杂性和侵入性，它主要用于研究。胰岛素抵抗稳态模型评估（HOMA-IR）和定量胰岛素敏感性检查指数（QUICKI）是临床环境中第二常用的胰岛素抵抗测试。这些测试基于测量空腹血糖和胰岛素水平。口服葡萄糖耐量试验（OGTT）、胰岛素耐量试验和松田指数是进一步阐明胰岛素敏感性的诊断程序。改进的技术，如胰岛素抑制试验和最小模型分析，为特殊临床情况提供了替代方法。此外，在这些测试中加入额外的测量指标，如腰围、血脂谱和炎症标志物，可以改善对胰岛素抵抗的评估。总之，识别胰岛素抵抗对于各种代谢性疾病的早期检测和治疗至关重要。为了做出明智的判断并改善患者护理，医护人员应该了解不同的可用诊断测试以及它们在每种情况下的使用方式。胰岛素抵抗的检测和监测需要进一步研究，以改进当前的诊断方法并创造新的、侵入性较小的技术。
