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Minimal model estimation of glucose absorption and insulin sensitivity from oral test: validation with a tracer method
Open accessAbstract
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 (R a 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 is 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 R a meal and S I, 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” R a meal and S I compare well with the “tracer” R a mealref and S Iref . We do this comparison on a database of 88 subjects, and it is very satisfactory: R a meal profiles agree well with the R a mealref and correlation of S Iref with S I 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.
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“Furthermore, use of the meal minimal model in conjunction with the triple tracer method permits robust model assessments of indices of insulin action on the periphery (SI) and on the liver (SIL), glucose effectiveness (SG), insulin secretion, and β-cell function (disposition index).[49][50][51][52][53][54][55][56][57][58][59][60][61]”
From Developing the UVA/Padova Type 1 Diabetes Simulator: Modeling, Validation, Refinements, and Utility (2023) · cites this paper as [56]
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Metadata
- Authors
- Dalla Man, C., Caumo, A., Basu, R., Rizza, R., Toffolo, G., & Cobelli, C.
- Affiliations
- University of Padua (IT)
- Venue
- American Journal of Physiology-Endocrinology and Metabolism
- Publisher
- American Physiological Society
- Published
- 2004-10
- Volume
- 287
- Issue
- 4
- Pages
- E637-E643
- ISSN
- 0193-1849 (ISSN-L)
- 1522-1555
- OpenAlex
- W2113594895
- Semantic Scholar
- 70f0547653f303f77c579b7da478c231e71203ad
- Cited by
- 198
- References
- 14
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 6 · 2023: 13 · 2022: 9 · 2021: 11 · 2020: 7 · 2019: 12 · 2018: 6 · 2017: 11 · 2016: 11 · 2015: 12 · 2014: 12 · 2013: 15 · 2012: 14
- FWCI
- 3.73
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- American Journal of Physiology-Endocrinology and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- Padua Research Archive (University of Padova) (submittedVersion, other-oa)
- Funders
- National Institutes of Health (RR-00585)
- National Institute on Aging (AG14383, P01AG014383)
- National Institute of Biomedical Imaging and Bioengineering (EB 01975, P41EB001975)
- National Center for Research Resources (RR-00585, M01RR000585)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- oral minimal model, insulin sensitivity, oral glucose tolerance test
- MeSH terms
- Absorption, Algorithms, Blood Glucose, Carbon Isotopes, Deuterium, Eating, Female, Glucose, Glucose Tolerance Test, Humans, Insulin, Insulin Resistance, Male, Middle Aged, Models, Biological, Tritium, Glucose Clamp Technique, Databases, Factual
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