{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:28:24Z","timestamp":1777984104882,"version":"3.51.4"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008713","name":"Diabetes Australia Research Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008713","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Impaired insulin sensitivity is an under\u2010recognised risk in Type 1 diabetes but is challenging to measure with \u2018gold\u2010standard\u2019 euglycaemic clamps. Adding stable\u2010isotope glucose distinguishes hepatic and muscle insulin action (assessed by endogenous glucose production [EGP] and glucose infusion rate [GIR], respectively). We therefore searched for a blood\u2010biomarker alternative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two\u2010step clamps were conducted in 40 adults with Type 1 diabetes, participating in the INTIMET trial (INsulin resistance in Type 1 diabetes managed with METformin, ACTRN12619001440112). Participants were characterised with 33 baseline biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Exhaustive search analyses derived a formula predicting an \u2018unfavourable GIR\u2019 (dichotomous variable: below median of 60.4\u2009\u03bcmol\/kg fat\u2010free mass [FFM]\/min) using: total daily insulin dose (TDI), fasting triglycerides (TGs), insulin\u2010like growth factor 1 and aspartate aminotransferase levels (area under the receiver operating characteristic curve (AUROC) 0.97,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001,\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      [Nagelkerke]\u2009=\u20090.83, 92.5% accuracy). An \u2018unfavourable EGP level\u2019 (above median of 6.2\u2009\u03bcmol\/kg FFM\/min) during low\u2010dose clamp was predicted by TDI, TGs, alkaline phosphatase and uric acid levels (AUROC 0.86,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001,\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      (Nagelkerke)\u2009=\u20090.50, 80% accuracy). A free online tool (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/bit.ly\/EGP-GIR-calculator\">https:\/\/bit.ly\/EGP-GIR-calculator<\/jats:ext-link>\n                      ) converts these variables into dichotomised EGP and GIR estimates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We demonstrate that clinical and research biomarkers can be used to estimate tissue specific insulin sensitivity in adults with Type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70517","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T10:12:52Z","timestamp":1770027172000},"page":"3238-3244","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Interactive online calculator for estimation of muscle and hepatic insulin sensitivity in adults with Type 1 diabetes using clinical and research biomarkers"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0995-4524","authenticated-orcid":false,"given":"Andrzej S.","family":"Januszewski","sequence":"first","affiliation":[{"name":"Sydney Pharmacy School University of Sydney  Camperdown New South Wales Australia"},{"name":"NHMRC Clinical Trials Centre University of Sydney  Camperdown New South Wales Australia"},{"name":"Department of Medicine University of Melbourne  Fitzroy Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8559-8387","authenticated-orcid":false,"given":"Jennifer R.","family":"Snaith","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism Garvan Institute of Medical Research  Darlinghurst New South Wales Australia"},{"name":"St Vincent's Clinical Campus University of New South Wales  Darlinghurst New South Wales Australia"},{"name":"Department of Diabetes and Endocrinology St Vincent's Hospital Sydney  Darlinghurst New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg M.","family":"Kowalski","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition, School of Medicine Deakin University  Geelong Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clinton R.","family":"Bruce","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science Deakin University  Geelong Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. Jane","family":"Holmes\u2010Walker","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology Westmead Hospital  Westmead New South Wales Australia"},{"name":"Sydney Medical School University of Sydney  Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia J.","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Melbourne  Fitzroy Victoria Australia"},{"name":"Baker Heart and Diabetes Institute  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerry R.","family":"Greenfield","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism Garvan Institute of Medical Research  Darlinghurst New South Wales Australia"},{"name":"St Vincent's Clinical Campus University of New South Wales  Darlinghurst New South Wales Australia"},{"name":"Department of Diabetes and Endocrinology St Vincent's Hospital 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