The hyperinsulinemic-euglycemic clamp in combination with glucose tracers is the gold standard to assess in vivo insulin sensitivity/resistance at the whole-body and tissue levels. KBI has developed this technique to evaluate insulin sensitivity or resistance in both lean and diabetic monkeys. 

In this technique, insulin is infused (5.0 mU/min per kg, iv) to induce hyperinsulinemia whereas glucose is simultaneously supplemented to maintain euglycemia. The glucose infusion rate (GIR) is the measure for the whole-body insulin sensitivity/resistance where hyperinsulinemia is matched between experimental groups. The glucose disposal rate (Rd) measures insulin sensitivity/resistance in skeletal muscle whereas the endogenous glucose production (EGP) indicates insulin sensitivity/resistance in the liver. 

Hyperinsulinemic-euglycemic clamp combined with glucose tracer in monkeys. EGP is measured by infusing non-radioactive 13C labelled D-glucose prior to the infusion of insulin and glucose. Rd is obtained from GIR and EGP (Diabetes 36:914,1987 and Am J Physiol 284:E531–E540,2003).