The Optimized Calculation Method for Insulin Dosage in an Insulin Tolerance Test (ITT): A Randomized Parallel Control Study.

Abstract

Objective: To explore the most suitable calculation method for insulin dosage in an insulin tolerance test (ITT) and to evaluate the clinical application value of the optimization coefficient (γ). Methods: In this study, 140 adult patients with congenital growth hormone deficiency (GHD) or acquired hypopituitarism were randomized into the following two groups: the conventional group (n = 70) and the optimized group (n = 70). Oral glucose tolerance tests (OGTTs), insulin release tests (IRTs), and ITTs were conducted. For ITTs, insulin doses were the product of body weight (kg) and related coefficient (0.15 IU/kg for the control group and γ IU/kg for the optimized group, respectively). Notably, γ was defined as -0.034 + 0.000176 × AUCINS + 0.009846 × BMI, which was based on our previous study. Results: In the ITTs, the rate of achieving adequate hypoglycemia with a single insulin dose was significantly higher for the optimized group compared with the conventional group (92.9 vs. 60.0%, P < 0.001). The optimized group required higher initial doses of insulin (0.23 IU/kg). Meanwhile, the two groups did not differ significantly in their nadir blood glucose (1.9 vs. 1.9 mmol/L, P = 0.828). Conclusion: This study confirmed that the proposed optimized calculation method for insulin dosage in ITTs led to more efficient hypoglycemia achievement, without increasing the incidence of serious adverse events.

• Authors: Yuwen Zhang, Shouyue Sun, Huiying Jia, Yan Qi, Jie Zhang, Lin Lin, Yuhong Chen, Weiqing Wang, Guang Ning
• Journal: Frontiers in endocrinology (Front Endocrinol (Lausanne)) Vol. 11 Pg. 202 ( 2020) ISSN: 1664-2392 [Print] Switzerland
• PMID: 32328036 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 Zhang, Sun, Jia, Qi, Zhang, Lin, Chen, Wang and Ning.

Chemical References

• Blood Glucose
• Insulin

Topics

• Adult
• Blood Glucose (drug effects, metabolism)
• Calibration
• Diagnostic Techniques, Endocrine (standards)
• Drug Dosage Calculations
• Dwarfism, Pituitary (blood, diagnosis, metabolism)
• Female
• Glucose Tolerance Test (methods, standards)
• Humans
• Hypoglycemia (blood, diagnosis, metabolism)
• Hypopituitarism (blood, diagnosis, metabolism)
• Insulin (administration & dosage)
• Insulin Resistance
• Male
• Young Adult