[The euglycemic insulin and hyperglycemic clamp technic. Methods for the determination of insulin sensitivity of tissues and glucose sensitivity of the B cell. A review].

The estimation of insulin-dependent glucose metabolism and endogenous insulin secretion in man by means of the euglycaemic insulin clamp- and hyperglycaemic clamp-technique is described. In the euglycaemic insulin clamp study plasma insulin concentration is acutely raised by approximately 100 microU/ml by a primed-continuous insulin infusion, while plasma glucose is maintained at the fasting level by means of a variable glucose infusion. Under these conditions of euglycaemic hyperinsulinaemia the amount of glucose infused plus the residual endogenous glucose release equals the amount of glucose taken up by all cells of the body. This rate of glucose metabolism ("M") thus represents an index of tissue sensitivity to exogenous insulin. In the hyperglycaemic clamp study plasma glucose is acutely raised by 125 mg/dl above basal. The amount of glucose infused to maintain hyperglycaemia too serves as a measure of tissue sensitivity to endogenous insulin. In addition, glucose-induced insulin secretion can be estimated on the basis of the plasma insulin response provided that insulin extraction by the liver remains constant.