The hyperbolic law—a 25-year perspective

Excerpt

In people with normal glucose tolerance, a decrease in insulin action is accompanied by up-regulation of insulin secretion, and vice versa. This is interpreted as a compensatory increase of insulin secretion, which maintains normoglycaemia despite decreased insulin sensitivity. In this issue of Diabetologia [1], Dr Hockaday deplores the fact that a landmark paper by the late Robert Turner and colleagues (himself included), which dates back to 1979, is rarely cited when this quasi-hyperbolic relationship is under discussion [2]. And Dr Hockaday is right, because the “hyperbola” in Fig. 7 of that paper, after two algebraic transformations (the insulin resistance factor being equivalent to 1/[insulin sensitivity] plus switching axes, the fraction of functioning beta cells being equivalent to beta cell function with opposite orientation), becomes the hyperbola now commonly used with acute insulin response (AIR) as a function of insulin sensitivity (Fig. 1a and b). In their abstract the authors already claim that “the height of basal plasma insulin is a function of the degree of insulin resistance”. Hence, Dr Hockaday appropriately claims that the concept was already shaped in their paper, which was published 25 years ago, 2 years before the classical paper of Bergman and co-workers [3].

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