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1 Department of Information Engineering, University of Padova, Padova, Italy
2 Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St. Louis, MO, USA
3 San Raffaele Scientific Institute, Milano, Italy
* To whom correspondence should be addressed. E-mail: cobelli{at}dei.unipd.it.
Measuring insulin sensitivity in presence of physiological changes in glucose and insulin concentrations, e.g. during a meal or OGTT, is important to better understand insulin resistance in a variety of metabolic conditions. Recently two oral minimal models have been proposed to measure overall insulin sensitivity (SI) and its selective effect on glucose disposal (SI*) from oral tests. SI and SI* have been successfully validated against multiple tracer meal estimates, but validation against euglycemic hyperinsulinemic clamp estimates is lacking. Here we do so in 21 subjects, who underwent both a multiple tracer OGTT and a labeled euglycemic hyperinsulinemic clamp. Correlation between minimal model SI, SI* and corresponding clamp estimates SIclamp, SI* clamp was satisfactory, respectively R=0.81, p<0.001 and R=0.71, p<0.001. SI was significantly lower than SIclamp (8.08 ± 0.89 vs 13.66 ± 1.69 10-4 dl/kg/min per µU/ml, p = 0.0002), while SI* and SI* clamp were very similar (8.17 ± 1.59 vs 8.84 ± 1.39 10-4 dl/kg/min per µU/ml, p = 0.52). These results add credibility to the oral minimal model method as a reliable physiological tool to estimate SI and SI* , also in large scale clinical trials.
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