Measuring and estimating insulin resistance in clinical and research settings.

AIM: This short review provides a theoretical outline for the measurement of insulin secretion and insulin resistance in humans. DATA SYNTHESIS: To evaluate the ability to secrete insulin, disposition index must be considered, and it is necessary to assess insulin sensitivity when insulin secretion is induced for assessment. The clinical application of the measurement of insulin resistance is also introduced for further debate. The term "insulin effectiveness" is clinical jargon for insulin sensitivity. However, for clinical application, you need at least two types of insulin effectiveness to calculate a basal and bolus insulin administration dose, while peripheral (mainly muscle) and liver are two major target organs for insulin action. The term "insulin sensitivity" may be used to express insulin action of the muscle or of specific organs through their insulin receptors, while "insulin resistance" may be used to express the necessity of a dose of insulin administration to suppress hepatic glucose production that can be induced by substrates, glucagon, catecholamine, and so on.
CONCLUSIONS: This article covers several important issues on the measurement of insulin secretion and resistance that had not been well described in other review articles, and may be of help for future clinical investigation. Copyright 2009 Elsevier B.V. All rights reserved.