Sir,
The recent report on the post-glucose insulin level in polycystic ovarian syndrome is very interesting.[1] In this work, the insulin resistance prediction by the 2-h post-glucose insulin level was studied. Saxena et al. concluded that the “2-h post-glucose insulin level appears to be a good indicator of IR. It can be a useful tool.”[1] It might seem that this simple technique can be a good tool for a resource-limited setting. However, there are some concerns in laboratory medicine. In a previous publication, it was well demonstrated that “the post-glucose load GI ratio cannot be used to determine the magnitude of insulin resistance.”[2] The positive finding in the present work might be by chance or due to the small number of studied subjects or uncontrolled confounding factors.
REFERENCES
- 1.Saxena P, Prakash A, Nigam A. Efficacy of 2-hour post glucose insulin levels in predicting insulin resistance in polycystic ovarian syndrome with infertility. J Hum Reprod Sci. 2011;4:20–2. doi: 10.4103/0974-1208.82355. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Dahan MH, Goldstein J. Serum sex hormone-binding globulin levels show too much variability to be used effectively as a screening marker for insulin resistance in women with polycystic ovary syndrome. Fertil Steril. 2006;86:934–41. doi: 10.1016/j.fertnstert.2006.02.108. [DOI] [PubMed] [Google Scholar]