Insulinemia/glycemia ratio – quotient of insulin concentration (mJ/l) and blood glucose (mg/dl). A coefficient greater than 0.3 indicates insulin resistance. This indicator can be used in the study performed in basic conditions – fasting as well as over time oral glucose tolerance test. Disturbance of endogenous insulin secretion is a limitation in this case.

HOMA-IR index (Homeostasis Model Assessment) – is a mathematical model that allows you to assess insulinemia in basic conditions and is calculated using the formula:

R = fasting insulin (mU/ml) × fasting blood glucose fasting (mmol/l)/ 22.5.

An R value > 0.91 ± 0.38 indicates insulin resistance.

QUICKI (Quantitative Insulin Sensitivity Check Index) – the index is calculated on the basis of the following formula: 1/(fasting insulin log (μU/mL) + log fasting blood glucose (mmol/l). A value less than 0.34 indicates insulin resistance.

Matsuda index – in this case, the appropriate formula is used:

100,000/fasting insulin (mU/mL) × fasting blood glucose (mg/dl) × mean blood glucose in the oral glucose tolerance test (OGTT, Oral Glucose Tolerance Test) × mean insulin value in OGTT. About insulin resistance an index value lower than 7.3 may indicate.

 Intravenous glucose tolerance test – the test is based on determining the tissue glucose assimilation coefficient K. This factor expresses the percentage of glucose that over time 1 minute will disappear from the extracellular space. Prior to the start of the test, blood glucose is measured, then the patient is infused with glucose at a dose of 0.33 g/kg and within an hour of glucose administration, blood glucose is measured at ten-minute intervals. The K value in people with normal glucose tolerance is 1.5–2.5. Value < 1.5 while elevated or normal plasma insulin concentration speaks volumes for insulin resistance.

Double intravenous glucose tolerance test – provides information on the action of exogenous insulin. During the test, in the first stage, glucose is administered intravenously at a dose of 0.33 g/kg, and in the second stage, another glucose in the same dose together with insulin (0.1 U/kg). As in the previous test, the tissue assimilation factor K is determined and the difference between the K values ​​is calculated.

Bergman method – This method uses a mathematical model to which 26 results of the patient’s insulin and glycaemia determinations are entered. The index of tissue sensitivity to insulin is determined. The test lasts 3 hours, the patient receives intravenous glucose at a dose of 0.3 g / kg and after 20 minutes an agent stimulating the body to secrete insulin is administered intravenously.

Source: Wiesław Grzesiuk, Dorota Szydlarska, Katarzyna Jóźwik. Insulin resistance in endocrinopathies. Endokrynologia, Otyłość i Zaburzenia Przemiany Materii 2008, tom 5, nr 1, s. 38–44. ISSN 1734–3321

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