[Evaluation of insulinosecretion and insulinosensitivity]

Insulin secretion and insulin sensitivity interact in concert to maintain glucose homeostasis. Various pathologies, especially type 2 diabetes, are characterized by defects in secretion and/or action of insulin and numerous drugs are able to partially correct these two defects. Therefore, the assessment of insulin secretion and insulin sensitivity is of interest to guide the choice of pharmacological treatments and to evaluate their efficacy. It could be performed by studying the couple of fasting insulin/glucose plasma concentrations or by performing dynamic tests, which mainly use the administration of glucose. The intimate relationship between insulin secretion and insulin sensitivity requires either appropriate tests that open the homeostatic feedback loop ("glucose clamp"), or sophisticated modeling approaches ("HOMA", "minimal model"). Insulin secretion should ideally be measured according to the corresponding insulin sensitivity. Dynamic tests are generally more informative than static measurements in the fasting state.