Test Details
Beta Cell Function and Risk Index
The Beta Cell Function and Risk Index is a calculation based on fasting glucose and insulin (or c-peptide) designed to give insights into beta cell function. It allows clinicians to assess baseline beta cell function, consider treatment options, and follow changes over time.
Methodology
Calculation
Patient Preparation
Fasting is required
Preferred Specimen
1.0 mL serum (0.5 mL minimum) collected in serum separator tube (SST/Tiger Top)
Alternate Specimen
- 1.0 mL EDTA plasma (0.5 mL minimum) collected in plasma separator tube (Pearl Top)
- Dried Blood collected on an AdvanceDx 100 card
Transport Temperature
Refrigerated (ship on frozen cold packs)
Stability
Refrigerated: 3 days
Lab Values
Beta Cell Function and Risk Index
- Optimal: Most favorable tertile of beta cell risk
- Borderline: Middle tertile of beta cell risk
- Increased Risk: Least favorable tertile of beta cell risk
Clinical Significance
Beta Cell Function and Risk Index
Beta cells in the pancreas secrete insulin to regulate blood glucose levels. Over time, beta cells can become progressively impaired, potentially resulting in prediabetes followed by type 2 diabetes.
The Homeostasis Model Assessment can be used to estimate Beta Cell Function (HOMA-B), Insulin Sensitivity (HOMA-S) and Insulin Resistance (HOMA- IR). These are calculations based on the relationship between fasting insulin and glucose.1-3 Clinical decision-making can be facilitated by characterizing a patient’s beta cell activity after accounting for the degree of insulin sensitivity.
The Boston Heart Beta Cell Function & Risk Index is a tool for patient engagement and motivation.
References:
- Wallace TM, et al. Use and abuse of HOMA modeling. Diabetes Care 2004 Jun;27(6):1487-95.
- Hill NR, et al. Expansion of the homeostasis model assessment of β-cell function and insulin resistance to enable clinical trial outcome modeling through the interactive adjustment of physiology and treatment
effects: iHOMA2.Diabetes Care. 2013 Aug;36(8):2324-30. - Song Y, et al. Insulin sensitivity and insulin secretion determined by homeostasis model assessment and risk of diabetes in a multiethnic cohort of women: the Women’s Health Initiative Observational Study.
Diabetes Care. 2007 Jul;30(7):1747-52
Treatment Options
Beta Cell Function and Risk Index
There are multiple treatment strategies for slowing or reversing progressive beta cell dysfunction, prediabetes, and type 2 diabetes. Reduction of excess body fat increases insulin sensitivity and reduces insulin resistance and hyperinsulinemia. Reduction of dietary intake of refined starch and sugar can reduce beta cell demand. Medications that reduce insulin resistance or beta cell demand can help delay the onset of type 2 diabetes.
References:
- 1.Sheng Z, et al. Effects of lifestyle modification and anti-diabetic medicine on prediabetes progress: A systematic review and meta-analysis. Front Endocrinol (Lausanne). 2019;10:455.
- Hu Y, et al. Short-term intensive therapy in newly diagnosed type 2 diabetes partially restores both insulin sensitivity and β-cell function in subjects with long-term remission Diabetes Care. 2011
Aug;34(8):1848-53 - Wang H, et al. Predictors of long-term glycemic remission after 2-week intensive insulin treatment in newly diagnosed type 2 diabetes. J Clin Endocrinol Metab. 2019 Jun 1;104(6):2153-2162
- Lean MEJ, et al. Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial. Lancet Diabetes
Endocrinol. 2019 May;7(5):344-355 - Al-Mrabeh et al. Hepatic lipoprotein export and remission of human type 2 diabetes after weight loss. Cell Metab. 2020 Feb 4;31(2):233-249.e4
- National Diabetes Statistics Report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2020.
