Comment on Piccinini and Bergman The Measurement of Insulin Clearance. Diabetes Care 2020;43:2296-2302.

We found interesting the review by Piccinini and Bergman (1) about the methods for assessing insulin clearance. However, some issues deserve comment. The authors claim that single-compartment description of C-peptide kinetics may provide limited accuracy. We agree that two-compartment description is typically more appropriate, but the single-compartment approach proved to be acceptable in glucose tolerance tests characterized by low dynamics. Indeed, the study by Volund et al. (2) reported that the C-peptide single-compartment model was acceptable for insulin and C-peptide infusion experiments in dogs and that C-peptide clearance was similar in the studied dogs and in humans from previous studies. Another study in humans showed that, even for the …