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Measurement of selective effect of insulin on glucose disposal from labeled glucose oral test minimal model

¹Department of Information Engineering, University of Padova, Padua; ²San Raffaele Scientific Institute, Milan, Italy; and ³Division of Endocrinology, Diabetes, Metabolism, and Nutrition Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota

Submitted 18 July 2004 ; accepted in final form 14 June 2005

The oral glucose minimal model (OMM) measures insulin sensitivity (S_I) and the glucose rate of appearance (R_a) of ingested glucose in the presence of physiological changes of insulin and glucose concentrations. However, S_I of OMM measures the overall effect of insulin on glucose utilization and glucose production. In this study we show that, by adding a tracer to the oral dose, e.g., of a meal, and by using the labeled version of OMM, OMM* to interpret the data, one can measure the selective effect of insulin on glucose disposal, . Eighty-eight individuals underwent both a triple-tracer meal with the tracer-to-tracee clamp technique, providing a model-independent reference of the R_a of ingested glucose () and an insulin-modified labeled intravenous glucose tolerance test (IVGTT*). We show that OMM* provides not only a reliable means of tracing the R_a of ingested glucose (R_{a meal}) but also accurately measures . We do so by comparing OMM* R_{a meal} with the model-independent provided by the tracer-to-tracee clamp technique, while OMM* is compared with both , obtained by using as known input , and with measured during IVGTT*.

insulin action; glucose utilization; tracer-to-tracee activity clamp; intravenous glucose tolerance test; oral glucose tolerance test

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