Hepatic insulin sensitivity in healthy and prediabetic subjects: From a dual- to a single-tracer oral minimal model

Roberto Visentin, Chiara Dalla Man, Rita Basu, Ananda Basu, Robert A. Rizza, Claudio Cobelli

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Recently, a model was proposed to assess hepatic insulin sensitivity during a meal, i.e., the ability of insulin to suppress glucose production (EGP), SIP. The model was developed on EGP data obtained from a triple-tracer meal and the tracer-to-tracee clamp technique and validated against the euglycemic hyperinsulinemic clamp. The aim of this study was to assess whether SIP can be obtained from plasma concentrations measured after a single-tracer meal by incorporating the above EGP model into the oral glucose minimal model by describing both glucose production and disposal (OMMPD). Triple-tracer meal data of two databases (20 healthy and 60 healthy and prediabetic subjects) were used. Virtually model-independent EGP estimates were calculated. OMMPD was identified on exogenous and endogenous glucose concentrations, providing indices of SIP, disposal insulin sensitivity (SID), and EGP. The model fitted the data well, and SP and were estimated with precision in both databases (SIp = 5.48 ± 0.54 10-4 dl-kg-1-min-1 per μU/ml and SID = 9.93 ± 2.18 10-4 dl-kg-1-min-1per μU/ml in healthy; SIp = 5.41 ± 3.55 10-4 dl-kg-1-min-1 per μU/ml and SID = 5.34 ± 6.17 10-4 dl-kg-1-min-1 per μU/ml, in healthy and prediabetic subjects). Estimated SIp and that derived from the triple-tracer EGP model were very similar on average. Moreover, the time course of EGP normalized to basal EGP (EGPb), and EGP/EGPb agreed with the results obtained using the triple-tracer method. In this study, we have demonstrated that SIP,SID, and EGP/EGPb time course can be estimated reliably from a single-tracer meal protocol in both healthy and prediabetic subjects.

Original languageEnglish (US)
Pages (from-to)E161-E167
JournalAmerican Journal of Physiology - Endocrinology and Metabolism
Volume309
Issue number2
DOIs
StatePublished - Jul 15 2015

Keywords

  • Glucose kinetics
  • Insulin resistance
  • Meal
  • Tracer

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Physiology
  • Physiology (medical)

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