13C- and 2H-labelled glucose compared for minimal model estimates of glucose metabolism in man

In the present study, we have investigated the use of 1-[(13)C]glucose and GC/combustion/isotope-ratio MS as an alternative to 6,6-[(2)H(2)]glucose and GC/MS in the determination of parameters of glucose metabolism using the IVGTT (intravenous glucose tolerance test) interpreted by labelled (hot) minimal models. The study has been done in four populations, normoglycaemics (subdivided into lean and obese individuals), subjects with impaired glucose tolerance and those with diabetes mellitus. Although the use of carbon label may in some circumstances be compromised by substrate recycling, our hypothesis was that this would not be an issue under the condition of suppression of hepatic glucose production during the short timescale of an IVGTT. In all four groups, we found that the methodology employing the carbon label gave equivalent results to those obtained using the conventional deuterated material, but the sensitivity of the measurement technique in the new approach was sufficient to allow an approx. 15-fold reduction in the quantity of isotope administered. In addition to the clear cost advantages, this represents a significant scientific advance in that true tracer status is more nearly attained in these measurements with near-physiological tracee loads.