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A model-based method for assessing insulin sensitivity from the oral glucose tolerance test.

A Mari1, G Pacini, E Murphy

  • 1Institute of Systems Science and Biomedical Engineering, National Research Council, Padova, Italy. mari@ladseb.pd.cnr.it

Diabetes Care
|April 6, 2001
PubMed
Summary

A new oral glucose insulin sensitivity (OGIS) index derived from oral glucose tolerance tests (OGTT) accurately predicts insulin sensitivity. This simpler method may be useful for clinical and epidemiological studies.

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Area of Science:

  • Endocrinology
  • Metabolic Research
  • Clinical Diagnostics

Background:

  • Existing insulin sensitivity (IS) methods using oral glucose tolerance tests (OGTT) are empirical.
  • A glucose-insulin model can derive a more accurate IS index from OGTT data.

Purpose of the Study:

  • To develop and validate an OGTT-based insulin sensitivity (IS) index, termed oral glucose insulin sensitivity (OGIS).
  • To compare the OGIS index against glucose clamp data for predicting glucose clearance.

Main Methods:

  • Collected glucose and insulin concentrations from 75-g OGTTs (2-h or 3-h) and euglycemic clamps in lean, obese, and type 2 diabetes subjects.
  • Developed the OGIS formula with six optimized constants to match clamp results.
  • Validated OGIS against glucose clamp-measured glucose clearance (Cl CLAMP) in an independent group.

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Main Results:

  • OGIS showed strong correlation with clamp-measured glucose clearance (R = 0.77, P < 0.0001) across all groups.
  • OGIS demonstrated similar reproducibility and discriminatory power between lean, obese, and type 2 diabetes groups as the clamp method.
  • The OGIS index yielded results consistent with established physiological principles.

Conclusions:

  • The oral glucose insulin sensitivity (OGIS) index is a reliable measure of insulin sensitivity, closely agreeing with glucose clamp results.
  • Due to its simplicity and minimal sample requirement (three blood samples), OGIS is suitable for clinical and large-scale epidemiological studies.