Assessment of circulating insulin using liquid chromatography‐mass spectrometry during insulin glargine treatment in type 2 diabetes: Implications for estimating insulin sensitivity and β‐cell function
Authors' conclusion
Despite glargine metabolites being detected in the insulin immunoassay, dynamic insulin responses can be used to assess β-cell responsiveness. However, given the cross-reactivity of the glargine metabolites in the insulin immunoassay, fasting-based measures of insulin sensitivity and β-cell function are biased.
Study context
- Population
- People with T2D 12 months after randomization to insulin glargine U-100; fasting and OGTT-stimulated plasma (19 participants) and fasting specimens (another 97 participants)
- Comparison
- Liquid chromatography-mass spectrometry (LC-MS) vs insulin immunoassay for circulating insulin during insulin glargine treatment
- Outcome
- Impact of glargine and metabolite cross-reactivity on insulin sensitivity and β-cell measures
Methodological detailsLast glargine dose before 10:00 PM the night before testing
- Last glargine dose before 10:00 PM the night before testing
Main finding
As reported in the abstract
- Glargine metabolized in plasma to M1 and M2, quantifiable by LC-MS
- Glargine and its metabolites cross-reacted by <100% in the insulin immunoassay
- Incomplete cross-reactivity caused systematic bias of fasting-based measures
- M1 and M2 did not change after glucose ingestion; no bias for IGI and iAUC insulin/glucose
Original publication
Assessment of circulating insulin using liquid chromatography‐mass spectrometry during insulin glargine treatment in type 2 diabetes: Implications for estimating insulin sensitivity and β‐cell function. Diabetes Obes Metab. Published 24 April 2023. doi:10.
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