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Hyperinsulinemic-Euglycemic Clamp

The hyperinsulinemic-euglycemic clamp is the golden standard to assess whole-body insulin sensitivity used for in-depth studies in humans. 

KBI has developed a hyperinsulinemic-euglycemic clamp technique to evaluate whole-body insulin sensitivity in both lean and diabetic monkeys (Macaca fascicularis) under conscious conditions. In this technique, insulin is intravenously infused to induce hyperinsulinemia within the physiological range whereas glucose is simultaneously infused at adjustable rates to maintain euglycemia. As endogenous glucose production (EGP) is shut down at 5.0 mU/min per kg of lean mass of insulin infusion, the glucose disappearance rate (Rd, namely insulin-stimulated glucose utilization) is equivalent to the glucose infusion rate (GIR) at steady the (clamp) state. Therefore, the GIR is a reliable measure for the whole-body insulin sensitivity. During the clamp period, plasma insulin  is measured every 30 mins)to ensure the hyperinsulinemia is comparable  between experimental groups.

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Tracer-based Hyperinsulinemic-Euglycemic Clamp

The suppression of EGP (mainly from liver) typically occurs at a lower dose of insulin than that required to stimulate Rd (mainly into skeletal muscle). EGP is measured at KBI by infusing a glucose tracer (non-radioactive 13C labelled D-glucose) prior to commencing the clamp procedures (before the infusion of insulin and glucose) at lower level of plasma insulin. 

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