[Estimation of insulin secretion rate in multiple sampled intravenous glucose tolerance test]

To measure and calculate insulin secretion rate(ISR) in multiple sampled intravenous glucose tolerance test (FSIVGTT) according to the two compartment model and standard parameters of the kinetics of connecting peptide (C-P) in vivo.

15 subjects with normal glucose tolerance and 11 type 2 diabetic patients took part in the study. Oral glucose tolerance test (OGTT) and FSIVGTT were performed. Glucose concentrations were measured by hexokinase method. Insulin (INS) and C-P concentrations were measured by radioimmunoassay. A computer procedure devised by our laboratory was used to calculate the value of ISR at each time point.

In the control group, serum INS and C-P concentrations reached the peak at 4 min, the second peak was not obvious. In type 2 diabetes, only 5 subjects had a small peak within 4 min, two curves reached its peak between 60 and 80 min. In the control group, ISR reached its peak 2 min after injection of glucose, that was earlier than INS and C-P curves in time sequence (P = 0.000), the second obvious peak was shown at 22 min. In type 2 diabetes, an obvious but small peak of ISR was shown at 2 min and all the patients had this peak.

It is necessary to take the process of metabolic clearance of INS and C-P into consideration, when blood concentration of INS and C-P were used as indexes to evaluate the secretion function of beta-cells. The ISR profile is more sensitive for investigation of the second phase of insulin secretion in the control group and the first phase in type 2 diabetes group.