TY - JOUR
T1 - Minimal model estimation of glucose absorption and insulin sensitivity from oral test
T2 - Validation with a tracer method
AU - Dalla Man, Chiara
AU - Caumo, Andrea
AU - Basu, Rita
AU - Rizza, Robert
AU - Toffolo, Gianna
AU - Cobelli, Claudio
PY - 2004/10
Y1 - 2004/10
N2 - Measuring insulin sensitivity during the physiological milieu of oral glucose perturbation, e.g., a meal or an oral glucose tolerance test, would be extremely valuable but difficult since the rate of appearance of absorbed glucose is unknown. The reference method is a tracer two-step one: first, the rate of appearance of glucose (Ra mealref) is reconstructed by employing the tracer-to-tracee ratio clamp technique with two tracers and a model of non-steady-state glucose kinetics; next, this R a mealref K used as the known input of a model describing insulin action on glucose kinetics to estimate insulin sensitivity (S Iref). Recently, a nontracer method based on the oral minimal model (OMM) has been proposed to estimate simultaneously the above quantities, denoted Ra meal and SI, respectively, from plasma glucose and insulin concentrations measured after an oral glucose perturbation. This last method has obvious advantages over the tracer method, but its domain of validity has never been assessed against a reference method. It is thus important to establish whether or not the "nontracer" Ra meal and SI compare well with the "tracer" Ra mealref and SIref. We do this comparison on a database of 88 subjects, and it is very satisfactory: R a meal profiles agree well with the Ra mealref and correlation of SIref with SI is r = 0.86 (P < 0.0001). We conclude that OMM candidates as a reliable tool to measure both the rate of glucose absorption and insulin sensitivity from oral glucose tests without employing tracers.
AB - Measuring insulin sensitivity during the physiological milieu of oral glucose perturbation, e.g., a meal or an oral glucose tolerance test, would be extremely valuable but difficult since the rate of appearance of absorbed glucose is unknown. The reference method is a tracer two-step one: first, the rate of appearance of glucose (Ra mealref) is reconstructed by employing the tracer-to-tracee ratio clamp technique with two tracers and a model of non-steady-state glucose kinetics; next, this R a mealref K used as the known input of a model describing insulin action on glucose kinetics to estimate insulin sensitivity (S Iref). Recently, a nontracer method based on the oral minimal model (OMM) has been proposed to estimate simultaneously the above quantities, denoted Ra meal and SI, respectively, from plasma glucose and insulin concentrations measured after an oral glucose perturbation. This last method has obvious advantages over the tracer method, but its domain of validity has never been assessed against a reference method. It is thus important to establish whether or not the "nontracer" Ra meal and SI compare well with the "tracer" Ra mealref and SIref. We do this comparison on a database of 88 subjects, and it is very satisfactory: R a meal profiles agree well with the Ra mealref and correlation of SIref with SI is r = 0.86 (P < 0.0001). We conclude that OMM candidates as a reliable tool to measure both the rate of glucose absorption and insulin sensitivity from oral glucose tests without employing tracers.
KW - Glucose kinetics
KW - Insulin resistance
KW - Meal
KW - Rate of appearance of glucose
KW - Tracer
UR - http://www.scopus.com/inward/record.url?scp=4544250123&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=4544250123&partnerID=8YFLogxK
U2 - 10.1152/ajpendo.00319.2003
DO - 10.1152/ajpendo.00319.2003
M3 - Article
C2 - 15138152
AN - SCOPUS:4544250123
SN - 0193-1849
VL - 287
SP - E637-E643
JO - American Journal of Physiology - Endocrinology and Metabolism
JF - American Journal of Physiology - Endocrinology and Metabolism
IS - 4 50-4
ER -