AUTHOR=Zhang Yuwen , Sun Shouyue , Jia Huiying , Qi Yan , Zhang Jie , Lin Lin , Chen Yuhong , Wang Weiqing , Ning Guang 

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

JOURNAL=Frontiers in Endocrinology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2020.00202

DOI=10.3389/fendo.2020.00202

ISSN=1664-2392

ABSTRACT=<p><bold>Objective:</bold> 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).</p><p><bold>Methods:</bold> 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 (<italic>n</italic> = 70) and the optimized group (<italic>n</italic> = 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 × AUC<sub>INS</sub> + 0.009846 × BMI, which was based on our previous study.</p><p><bold>Results:</bold> 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%, <italic>P</italic> &lt; 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, <italic>P</italic> = 0.828).</p><p><bold>Conclusion:</bold> 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.</p>