Measuring and estimating insulin resistance in clinical and research settings
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The article discusses how to measure insulin resistance in muscle, liver, and adipose tissue in human participants. The most frequently used methodologies to evaluate insulin resistance are described in detail starting from the gold standard, that is, the euglycemic hyperinsulinemic clamp, to the intravenous glucose tolerance test, surrogate indices based on fasting measurements, or dynamic tests (such as oral glucose or mixed meal tolerance tests). The accuracy, precision, and reproducibility of the tests as well as cutoff values are reported.
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Insulin resistance can also be measured clinically with the HOMA-IR index from fasting insulin or C-peptide and fasting glucose concentrations, including in people with T2D unless on insulin treatment.
“insulin resistance can also be measured clinically with the HOMA-IR index from fasting insulin or C-peptide and fasting glucose concentrations, including in people with T2D (unless on insulin treatment). 219 -221”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [221]
The 'Alternative tests' section (page not provided) gives HOMA-IR as an index calculated from fasting insulin and glucose, and its cutoff discussion includes participants with diabetes. Our copy does not establish that C-peptide can replace insulin in HOMA-IR or specify the exception for people receiving insulin treatment. (LLM, conf=0.86)
Experimental — accuracy not yet measured
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- Authors
- Gastaldelli, A.
- Affiliations
- Istituto di Fisiologia Clinica (IT)
- Corresponding author
- Gastaldelli, Amalia
- ORCID
- Gastaldelli, Amalia
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2022-07-27
- Volume
- 30
- Issue
- 8
- Pages
- 1549-1563
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- PMC
- PMC9542105
- OpenAlex
- W4288067929
- Cited by
- 244
- References
- 94
- Citations by year
- 2026: 68 · 2025: 87 · 2024: 63 · 2023: 23 · 2022: 2 · 2021: 1
- FWCI
- 6.30
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Obesity (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- H2020 Marie Skłodowska-Curie Actions (mtFOIE GRAS No. 734719)
- Innovative Medicines Initiative (SOPHIA No. 875534)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- insulin resistance, hyperinsulinemic-euglycemic clamp, intravenous glucose tolerance test, oral glucose tolerance test, mixed meal tolerance test, surrogate indices, skeletal muscle insulin sensitivity, hepatic insulin resistance, adipose tissue insulin resistance, cut-off values
- MeSH terms
- Blood Glucose, Glucose Tolerance Test, Humans, Insulin, Insulin Resistance, Reproducibility of Results, Glucose Clamp Technique, Glucose Intolerance
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