Insulin Sensitivity Test Using a Somatostatin Analogue, Octreotide (Sandostatin®)

Abstract

To assess the validity of the steady-state plasma glucose (SSPG) method using octreotide (Sandostatin), we compared the SSPG method with the euglycemic hyperinsulinemic clamp technique in ten non-obese, insulin-dependent diabetic patients. The SSPG method was performed by intravenous infusion of octreotide (0.5 microgram/min), insulin (2 mU/kg/min) and glucose (9 mg/kg/min) for 180 min. Octreotide suppressed endogenous growth hormone, glucagon and insulin secretion. A steady state condition was reached by 90 min, and the mean value of SSPG at 150 and 180 min was used as the index of insulin sensitivity. The euglycemic hyperinsulinemic clamp technique was performed with an artificial endocrine pancreas (Biostator), and insulin sensitivity was expressed as the glucose disposal rate (GDR) from 150-180 min. There was a significant correlation (r = 0.91, p < 0.001) between the results of the two methods. In conclusion, measurement of SSPG, using octreotide to suppress endogenous insulin secretion, is a reliable method to assess insulin sensitivity in man.

Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage

“…Indeed, since there are no variable infusions with the IST, steady-state conditions are more easily achieved with the IST than with the glucose clamp. Estimates of insulin sensitivity determined by SSPG correlate well with reference standard glucose clamp estimates in normal subjects (r ϭ 0.93) and in patients with type 2 diabetes mellitus (r ϭ 0.91) (43,69). Indeed, SSPG has positive predictive power for cardiovascular disease events and onset of type 2 diabetes (36,103).…”

Deficiency of phosphofructo-1-kinase/muscle subtype in humans impairs insulin secretion and causes insulin resistance.

“…The IST has been demonstrated to be highly correlated with the results of the hyperinsulinemic euglycemic clamp (32) ( r ϭ 0.93 [30] and r ϭ 0.91 [33], respectively). Since octreotide has been described to decrease liver glycolysis (34), we preferred this test due to methodological problems with the clamp as given above (15), and our experience with son I confirming absence of insulin resistance.…”

Visceral Fat Accumulation Contributes to Insulin Resistance, Small-Sized Low-Density Lipoprotein, and Progression of Coronary Artery Disease in Middle-Aged Non-Obese Japanese Men

“…It was obtained by the method of Mimura et al 22 after an overnight fast, intravenous catheters were placed in both arms. Blood was drawn from one arm for measuring plasma glucose and insulin concentrations, and the other arm was used for the administration of test substances.…”