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Am J Physiol Endocrinol Metab 274: E592-E599, 1998;
0193-1849/98 $5.00
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Vol. 274, Issue 4, E592-E599, April 1998

Insulin sensitivity and glucose effectiveness: minimal model analysis of regular and insulin-modified FSIGT

Giovanni Pacini1, Giancarlo Tonolo2, Maria Sambataro3, Mario Maioli2, Milco Ciccarese2, Enrico Brocco3, Angelo Avogaro4, and Romano Nosadini2

1 Institute of Systems Science and Biomedical Engineering (LADSEB), Italian National Research Council, 35127 Padua; 2 Institute of Clinical Medicine, University of Sassari, 07100 Sassari; and 3 Institute of Internal Medicine and 4 Department of Clinical and Experimental Medicine, University of Padova, 35128 Padua, Italy

The minimal model is widely used to evaluate insulin action on glucose disappearance from frequently sampled intravenous glucose tolerance tests (FSIGT). The common protocols are a regular (rFSIGT, single injection of 0.3 g/kg of glucose) and an insulin-modified test (mFSIGT, with an additional insulin administration at 20 min). This study compared the insulin sensitivity index (SI) and glucose effectiveness (SG) obtained in the same individual (16 normal subjects) with the two tests. SI was 7.11 ± 0.80 10-4 · min-1 · µU-1 · ml in rFSIGT and 6.96 ± 0.83 in mFSIGT (P = 0.656), regression r = 0.92, P < 0.0001; SG was 0.0260 ± 0.0028 min-1 and 0.0357 ± 0.0052, respectively, statistically different (P = 0.013) but still with a good regression (r = 0.66, P = 0.0051). SG and insulin amount during the early period correlated (r = 0.6, P = 0.015 in rFSIGT and r = 0.76, P = 0.0006 in mFSIGT). In summary, both FSIGTs with minimal model analysis provide the same SI, which is a very robust index. SG was different by 28% due probably to the relationship between SG and the amount of circulating insulin. In studies comparing groups, the simpler rFSIGT can still be used with the advantage of accounting for endogenous insulin, thus offering the possibility of direct inferences on the beta -cell activity.

frequently sampled intravenous glucose tolerance test; glucose tolerance; minimal model protocols; insulin action


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