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Intravenous Glucose Tolerance Test-Derived Insulin Sensitivity Changes during the Menstrual Cycle^*

CECILIA T. VALDES and KAREN E. ELKIND-HIRSCH

Departments of Obstetrics and Gynecology and Medicine, Baylor College of Medicine Houston, Texas 77054

Address requests for reprints to: C. T. Valdes, M.D., Obstetrical and Gynecological Associates, 7550 Fannin, Houston, Texas 77054.

Using glucose tolerance tests or a glucose clamp some studies report impaired insulin sensitivity during the luteal phase of the menstrual cycle, while others find no change in insulin sensitivity. Tissue sensitivity to insulin and glucose effectiveness can be estimated using the minimal model analysis of an iv glucose tolerance test (IVGTT), but this method has never been applied to evaluate the impact of the menstrual cycle on these parameters. We, therefore, studied eight cycling women using tolbutamide-modified IVGTTs during three different phases of the same menstrual cycle: early follicular, midcycle, and midluteal. Insulin sensitivity (S₁) and glucose effectiveness were derived using insulin and glucose levels obtained from tolbutamide-modified IVGTTs and analyzed with the minimal model computer program. The mean S₁ (x10_–4/min·µU/mL) decreased in a stepwise fashion from the follicular level of 6.20 ± 0.91 to a midcycle level of 4.95 ± 0.73 and was lowest in the luteal phase (3.20 ± 0.25; P < 0.007). No change in glucose effectiveness occurred as a function of the menstrual cycle. These findings indicate a significant decrease in insulin sensitivity in the luteal phase of the normal menstrual cycle, but no significant change at midcycle.

^* Presented in part at the Annual Meeting of the Society For Gynecologic Investigation, St. Louis, MO, 1990. This work was supported by the Division of Research Resources of the NIH under Grant MO1-RR-00350 and a grant from the Women’s Fund of Houston, TX.

Recipient of an American College of Obstetrics and Gynecology/Ortho Fellowship Grant 89–90.

Received June 18, 1990.

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