Evaluation of insulin sensitivity and beta-cell function indexes obtained from minimal model analysis of a meal tolerance test

Diabetes. 2004 May;53(5):1201-7. doi: 10.2337/diabetes.53.5.1201.

Abstract

Modeling analysis of glucose, insulin, and C-peptide following a meal has been proposed as a means to estimate insulin sensitivity (S(i)) and beta-cell function from a single test. We compared the model-derived meal indexes with analogous indexes obtained from an intravenous glucose tolerance test (IVGTT) and hyperglycemic clamp (HGC) in 17 nondiabetic subjects (14 men, 3 women, aged 50 +/- 2 years [mean +/- SE], BMI 25.0 +/- 0.7 kg/m(2)). S(i) estimated from the meal was correlated with S(i) estimated from the IVGTT and the HGC (r = 0.59 and 0.76, respectively; P < 0.01 for both) but was approximately 2.3 and 1.4 times higher (P < 0.05 for both). The meal-derived estimate of the beta-cell's response to a steady-state change in glucose (static secretion index) was correlated with the HGC second-phase insulin response (r = 0.69; P = 0.002), but the estimated rate-of-change component (dynamic secretion index) was not correlated with first-phase insulin release from either the HGC or IVGTT. Indexes of beta-cell function obtained from the meal were significantly higher than those obtained from the HGC. In conclusion, insulin sensitivity and beta-cell indexes derived from a meal are not analogous to those from the clamp or IVGTT. Further work is needed before these indexes can be routinely used in clinical and epidemiological studies.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Blood Glucose / analysis
  • C-Peptide
  • Female
  • Glucose Clamp Technique
  • Glucose Tolerance Test
  • Homeostasis
  • Humans
  • Insulin / blood
  • Insulin / metabolism
  • Insulin Resistance*
  • Insulin Secretion
  • Islets of Langerhans / metabolism*
  • Male
  • Middle Aged
  • Models, Biological*
  • Postprandial Period*
  • Reference Values

Substances

  • Blood Glucose
  • C-Peptide
  • Insulin