<P> Patients initially receive 25 μg of octreotide (Sandostatin) in 5 mL of normal saline over 3 to 5 minutes via intravenous infusion (IV) as an initial bolus, and then, are infused continuously with an intravenous infusion of somatostatin (0.27 μg / m / min) to suppress endogenous insulin and glucose secretion . Next, insulin and 20% glucose are infused at rates of 32 and 267 mg / m / min, respectively . Blood glucose is checked at zero, 30, 60, 90, and 120 minutes, and thereafter, every 10 minutes for the last half - hour of the test . These last four values are averaged to determine the steady - state plasma glucose level (SSPG). Subjects with an SSPG greater than 150 mg / dL are considered to be insulin - resistant . </P> <P> Given the complicated nature of the "clamp" technique (and the potential dangers of hypoglycemia in some patients), alternatives have been sought to simplify the measurement of insulin resistance . The first was the Homeostatic Model Assessment (HOMA), and a more recent method is the Quantitative insulin sensitivity check index (QUICKI). Both employ fasting insulin and glucose levels to calculate insulin resistance, and both correlate reasonably with the results of clamping studies . Wallace et al. point out that QUICKI is the logarithm of the value from one of the HOMA equations . </P> <P> The primary treatment for insulin resistance is exercise and weight loss . Research shows that a low - carbohydrate diet may help . Both metformin and thiazolidinediones improve insulin resistance, but only are approved therapies for type 2 diabetes, not for insulin resistance . By contrast, growth hormone replacement therapy may be associated with increased insulin resistance . </P> <P> Metformin has become one of the more commonly prescribed medications for insulin resistance . Unfortunately, Metformin also masks Vitamin B12 deficiency, so accompanying sub-lingual Vitamin B12 tablets are recommended . </P>

If body cells have too few receptors for insulin