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Am J Physiol Endocrinol Metab (January 4, 2005). doi:10.1152/ajpendo.00058.2004
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Submitted on February 4, 2004
Accepted on December 14, 2004

An Integrated Model Of Hepatic And Peripheral Glucose Regulation For Estimation Of Endogenous Glucose Production During The Hot IVGTT

Kevin M. Krudys1, Michael G. Dodds1, Stephanie M. Nissen1, and Paolo Vicini1*

1 Department of Bioengineering, University of Washington, Seattle, WA, USA

* To whom correspondence should be addressed. E-mail: vicini{at}u.washington.edu.

We have developed a new model to describe endogenous glucose kinetics during a labeled (hot) intravenous glucose tolerance test (IVGTT) in order to derive a time profile of endogenous glucose production (EGP). We reanalyzed data from a previously published study [P. Vicini et al. Am. J. Physiol. 276 (Endocrinol. Metab. 39): E285-E294, 1999], in which insulin modified [6,6-2H2]glucose labeled IVGTTs (0.33 g kg-1 of glucose) were performed in 10 normal subjects. In addition, a second tracer ([U-13C]glucose) was infused in a variable rate in order to clamp the endogenous glucose tracer-to-tracee ratio (TTR). Our new model describing endogenous glucose kinetics was incorporated into the two compartment hot minimal model structure. The model gave estimates of glucose effectiveness (SG2* = 1.54±0.31 ml.kg-1.min-1) [mean±SE], insulin sensitivity (SI2* = 37.74±5.23 104 dl.kg-1.min-1.µU-1.ml) as well as a new parameter describing the sensitivity of EGP to the inhibitory effect of insulin (IC50 = 0.0195±.0046 min-1). The model additionally provided an estimate of the time course of EGP showing almost immediate inhibition, followed by a secondary inhibitory effect caused by infusion of insulin, and a large overshoot as EGP returns to its basal value. Our estimates show very good agreement with those obtained via deconvolution and the model-independent TTR clamp technique. These results suggest the new integrated model can serve as a simple one-step approach to obtain metabolic indexes, while also providing a parametric description of EGP.




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C. D. Man, G. Toffolo, R. Basu, R. A. Rizza, and C. Cobelli
Use of labeled oral minimal model to measure hepatic insulin sensitivity
Am J Physiol Endocrinol Metab, November 1, 2008; 295(5): E1152 - E1159.
[Abstract] [Full Text] [PDF]




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