Euglycemichyperinsulinemic

Euglycemichyperinsulinemic, in the common usage of physiology and metabolic research, refers to the euglycemic hyperinsulinemic clamp technique. This method is used to quantify human insulin sensitivity by maintaining a stable, normal blood glucose level while presenting a sustained, elevated insulin concentration. The core idea is to drive insulin’s glucose-luptake effects and measure how much exogenous glucose must be infused to keep glycemia at a constant level, yielding a metric often called the glucose infusion rate or M value.

Procedure typically begins after an overnight fast. An insulin infusion is started to raise plasma insulin to a high, steady level. A variable-rate infusion of glucose solution is administered and continuously adjusted based on frequent blood glucose measurements to maintain euglycemia, commonly around 90 mg/dL (5 mmol/L). Measurements are taken at regular intervals, and the rate of glucose infused to maintain euglycemia provides a direct index of whole-body insulin sensitivity. In some variants, isotopic glucose tracers are used to distinguish endogenous glucose production from peripheral glucose disposal.

Interpretation centers on the M value: a higher rate indicates greater insulin sensitivity, while a lower rate indicates insulin resistance. When tracers are used, researchers can separately assess hepatic versus peripheral insulin sensitivity. The technique is primarily a research tool, providing detailed insights into metabolic function under controlled conditions.

History and context: the clamp technique was developed in the 1970s by researchers including DeFronzo. It remains a gold standard for studying insulin action, especially in studies of obesity, type 2 diabetes, aging, and pharmacologic interventions. Limitations include its resource intensity and need for specialized personnel and equipment, restricting routine clinical use.