Insulin sensitivity indexes from a single sample in nonobese Japanese type 2 diabetic patients: comparison with minimal model analysis.

I n my Presidential Address in June of 1998 (1), I proudly announced that the most recent Five Year Plan adopted by the American Diabetes Association contained the goal of allocating one of every three dollars of total public support to research awards and grants by the end of 5 years. I pledged to keep the members of the professional section apprised of our progress toward that goal. The general approach envisaged gradual increases during the first three years, with more steep increases during the final two years. Table 1 depicts our performance from the year before the Five Year Plan went into effect through this past fiscal year. The final two years are now upon us. Are we up to the huge challenge that re-mains? I'll let you know next year. Address e-mail correspondence to madavids @cdrewu.edu. Reference 1. Davidson MB: Diabetes research and diabetes care: where do we stand? (1998 Presidential Address). Comparison with minimal model analysis I nsulin resistance is important not only in obesity and diabetes but also in essential hypertension, dyslipidemia, and atherosclerotic cardiovascular disease (1). We recently demonstrated that the homeostasis model assessment for insulin resistance (HOMA-IR) proposed by Matthews et al. (2) is validated against the minimal model– derived insulin sensitivity index (MINMOD-SI) in type 2 diabetic patients (3). Although the relationship between HOMA-IR and MINIMOD-SI in these patients was statistically significant, the correlation coefficient was low (r ϭ 0.459, P ϭ 0.021) (3). Therefore, a more highly correlated simple index is needed to measure insulin resistance in large type 2 diabetic populations. The major drawback of HOMA-IR is that when the glucose or insulin concentration increases, the value is overestimated. Furthermore, HOMA-IR is not linear over wide ranges of insulin sensitivity in man (4). Katz et al. (5) recently proposed the quantitative insulin sensitivity check index (QUICKI) [1/(log glucose ϩ log insulin)] as a novel index of insulin sensitivity. They demonstrated that the correlation between the euglycemic clamp and QUICKI is significantly better than the correlation between the euglyce-mic clamp and HOMA-IR in 56 subjects, including diabetic patients. We proposed another three insulin sensitivity indexes based on QUICKI. To the best of our knowledge, however, the relationships between MINMOD-SI and these formulas , including QUICKI, have not been fully investigated in type 2 diabetic patients. Twenty-five nonobese Japanese type 2 diabetic patients underwent the minimal model approach to measure insulin sensitivity index …