title: A mathematical model of the euglycemic hyperinsulinemic clamp.
abstract: BACKGROUND
  The Euglycemic Hyperinsulinemic Clamp (EHC) is the most widely used experimental procedure for the determination of insulin sensitivity, and in its usual form the patient is followed under insulinization for two hours. In the present study, sixteen subjects with BMI between 18.5 and 63.6 kg/m(2) were studied by long-duration (five hours) EHC.
  
  
  RESULTS
  From the results of this series and from similar reports in the literature it is clear that, in obese subjects, glucose uptake rates continue to increase if the clamp procedure is prolonged beyond the customary 2 hours. A mathematical model of the EHC, incorporating delays, was fitted to the recorded data, and the insulin resistance behaviour of obese subjects was assessed analytically. Obese subjects had significantly less effective suppression of hepatic glucose output and higher pancreatic insulin secretion than lean subjects. Tissue insulin resistance appeared to be higher in the obese group, but this difference did not reach statistical significance.
  
  
  CONCLUSIONS
  The use of a mathematical model allows a greater amount of information to be recovered from clamp data, making it easier to understand the components of insulin resistance in obese vs. normal subjects.
authors.affiliation: CNR-IASI BioMatLab, Rome, Italy. umberto.picchini@biomatematica.it
authors.forename: Umberto
authors.initials: U
authors.lastname: Picchini
authors.forename: Andrea
authors.initials: A
authors.lastname: De Gaetano
authors.forename: Simona
authors.initials: S
authors.lastname: Panunzi
authors.forename: Susanne
authors.initials: S
authors.lastname: Ditlevsen
authors.forename: Geltrude
authors.initials: G
authors.lastname: Mingrone
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008954:Models, Biological; D009765:Obesity / Q000097:blood / Q000503:physiopathology
chemical_list: D001786:Blood Glucose; D007328:Insulin