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Am J Physiol Endocrinol Metab (June 21, 2005). doi:10.1152/ajpendo.00299.2004
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Submitted on July 8, 2004
Accepted on June 14, 2005

Measurement of Selective Effect of Insulin on Glucose Disposal from Labeled Glucose Oral Test Minimal Model

Chiara Dalla Man1, Andrea Caumo2, Rita Basu3, Robert Rizza3, Gianna Toffolo1, and Claudio Cobelli1*

1 Department of Information Engineering, University of Padova, Padova, Italy
2 San Raffaele Scientific Institute, Milano, Italy
3 Department of Internal Medicine, Mayo Clinic and Foundation, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Rochester, MN, USA

* To whom correspondence should be addressed. E-mail: cobelli{at}dei.unipd.it.

The oral glucose minimal model (OMM) measures insulin sensitivity (SI) and the glucose rate of appearance of ingested glucose in the presence of physiological changes of insulin and glucose concentrations. However, SI 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, SI*. 88 individuals have undergone both a triple tracer meal with the tracer-to-tracee clamp technique providing a model-independent measure of the appearance rate of ingested glucose (Ramealref ) and an insulin modified labeled IVGTT, (IVGTT*). We show that OMM* provides not only a reliable mean of tracing the appearance of ingested glucose (Rameal) but also accurately measures SI*. We do so by comparing OMM* Rameal with the model-independent Ramealref provided by the tracer-to-tracee clamp technique, while OMM* SI* is compared both to SI* ref obtained by using as known input Ramealref as well as to SI* measured during IVGTT*.




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