Interactive calculator to estimate insulin sensitivity in type 1 diabetes

Author:

Januszewski Andrzej S123ORCID,Niedzwiecki Pawel4,Sachithanandan Nirupa2,Ward Glenn M2,O’Neal David N2,Zozulinska‐Ziolkiewicz Dorota A4,Uruska Aleksandra A4,Jenkins Alicia J125

Affiliation:

1. NHMRC Clinical Trials Centre University of Sydney Sydney New South Wales Australia

2. Department of Medicine University of Melbourne Fitzroy Victoria Australia

3. Sydney Pharmacy School University of Sydney Sydney New South Wales Australia

4. Department of Internal Medicine and Diabetology Poznan University of Medical Sciences Poznan Poland

5. Baker Heart and Diabetes Institute Melbourne Victoria Australia

Abstract

ABSTRACTThe gold standard for measuring insulin sensitivity (IS) is the hyperinsulinemic–euglycemic clamp, a time, costly, and labor‐intensive research tool. A low insulin sensitivity is associated with a complication‐risk in type 1 diabetes. Various formulae using clinical data have been developed and correlated with measured IS in type 1 diabetes. We consolidated multiple formulae into an online calculator (bit.ly/estimated‐GDR), enabling comparison of IS and its probability of IS <4.45 mg/kg/min (low) or >6.50 mg/kg/min (high), as measured in a validation set of clamps in 104 adults with type 1 diabetes. Insulin sensitivity calculations using different formulae varied significantly, with correlations (R2) ranging 0.005–0.87 with agreement in detecting low and high glucose disposal rates in the range 49–93% and 89–100%, respectively. We demonstrate that although the calculated IS varies between formulae, their interpretation remains consistent. Our free online calculator offers a user‐friendly tool for individual IS calculations and also offers efficient batch processing of data for research.

Publisher

Wiley

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