CoChat
Sign Up
Cited by 42Diabetes Management and ResearchPancreatic function and diabetesDiabetes, Cardiovascular Risks, and Lipoproteins

Accurate Measurement of Postprandial Glucose Turnover: Why Is It Difficult and How Can It Be Done (Relatively) Simply?

Open access
Rizza, Robert A., Toffolo, Gianna, Cobelli, Claudio·2016·Diabetes
DOI 10.2337/db15-1166PMC PMC4839208
Open this paper in CoChat — free accountOpen PDF

Abstract

Fasting hyperglycemia occurs when an excessive rate of endogenous glucose production (EGP) is not accompanied by an adequate compensatory increase in the rate of glucose disappearance (Rd). The situation following food ingestion is more complex as the amount of glucose that reaches the circulation for disposal is a function of the systemic rate of appearance of the ingested glucose (referred to as the rate of meal appearance [Rameal]), the pattern and degree of suppression of EGP, and the rapidity of stimulation of the Rd. In an effort to measure these processes, Steele et al. proposed what has come to be referred to as the dual-tracer method in which the ingested glucose is labeled with one tracer while a second tracer is infused intravenously at a constant rate. Unfortunately, subsequent studies have shown that although this approach is technically simple, the marked changes in plasma specific activity or the tracer-to-tracee ratio, if stable tracers are used, introduce a substantial error in the calculation of Rameal, EGP, and Rd, thereby leading to incorrect and at times misleading results. This Perspective discusses the causes of these so-called “nonsteady-state” errors and how they can be avoided by the use of the triple-tracer approach.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.2337/db15-1166

Cites

35 of 35 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • 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).

    “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 [54]

    Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

  • These sophisticated models became possible because of unique phenotypic data of carbohydrate metabolism obtained from studies in >200 adults and children applying the triple tracer technique.

    “These sophisticated models became possible because of unique phenotypic data of carbohydrate metabolism obtained from studies conducted in >200 adults and children applying the triple tracer technique to derive key metabolic indices and parameters.[48][49][50][51][52][53][54]”

    From Developing the UVA/Padova Type 1 Diabetes Simulator: Modeling, Validation, Refinements, and Utility (2023) · cites this paper as [54]

    The Discussion (page not specified) reports more than 600 triple-tracer studies in more than 300 subjects, including children and adults. The paper also describes metabolic measurements enabled by the method, but it does not say that data from those studies made the cited sophisticated models possible. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. [15]15. Hother-Nielsen O, Henriksen JE, Staehr P, Beck-Nielsen H. Labelled glucose infusate technique in clamp studies. Is precise matching of glucose specific activity important? Endocrinol Metab (Seoul) 1995;2:275-287

Cited by

Sorted by citations

Related

Authors
Rizza, R. A., Toffolo, G., & Cobelli, C.
Affiliations
  • Mayo Clinic (US)
  • University of Padua (IT)
Corresponding author
Rizza, Robert A.
ORCID
Venue
Diabetes
Publisher
American Diabetes Association
Published
2016-04-15
Volume
65
Issue
5
Pages
1133-1145
ISSN
  • 0012-1797 (ISSN-L)
  • 1939-327X
DOI
10.2337/db15-1166
PMC
PMC4839208
OpenAlex
W2341790619
Semantic Scholar
69143aef49e1fe127202b3b0ba88e08b692f0d8a
Cited by
42
References
35
Citations by year
2026: 3 · 2025: 1 · 2023: 7 · 2022: 1 · 2021: 4 · 2020: 4 · 2019: 6 · 2018: 10 · 2017: 6
FWCI
7.36
Type
journal article
Language
en
Open access
Locations
  • Diabetes (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion)
Funders
  • Mayo Clinic
  • Università degli Studi di Padova
  • National Institutes of Health
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK029953, R01DK082396, R37DK029953)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
dual-tracer method, endogenous glucose production, glucose disappearance, fasting hyperglycemia
MeSH terms
Algorithms, Animals, Blood Glucose, Carbon Isotopes, Carbon Radioisotopes, Deuterium, Dietary Carbohydrates, Gluconeogenesis, Glucose, Glycogen, Glycolysis, Humans, Intestinal Absorption, Models, Biological, Tritium, Reproducibility of Results, Postprandial Period, Carbohydrate Metabolism, Glycogenolysis

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review