Measurement of glucose homeostasis in vivo: glucose and insulin tolerance tests.

The feasibility of investigating glucose tolerance and insulin action and secretion in vivo in mouse models has provided major insights into both type 2 diabetes pathogenesis and the identification of novel strategies to treat this common disorder. When initial studies provide evidence for altered levels of insulin and/or glucose in the animal blood, a number of well-characterized tests can be adopted to estimate glucose homeostasis and insulin action and secretion in vivo. These tests include model assessments, glucose and insulin sensitivity studies, and glucose clamps. None of them can be considered appropriate under all circumstances and there is significant variation in their complexity, technical ease, and invasiveness. Thus, while the euglycaemic hyperinsulinemic clamp represents the gold standard for measuring in vivo insulin action, less labor-intensive as well as invasive techinques are usually considered as the initial approach to evaluate glucose homeostasis. This section focuses on glucose and insulin tolerance tests. The clamp technique is described in Chapter 15.