Application of minimal models to measuring insulin sensitivity

Bergman's minimal model of glucose dynamics was used to analyse intravenous glucose tolerance tests in non-diabetic and non-insulin dependent diabetic subjects (NIDDM). This analytical approach yielded an index of insulin sensitivity in 63% of the non-diabetic and 15% of NIDDM subjects. When the model was constrained to search for the most likely parameter solutions, all the non-diabetic and 96% of the diabetic plasma insulin-glucose curves could be solved. A comparison of the insulin sensitivity index derived from this constrained minimal model against the metabolic clearance rate of glucose during a hyperinsulinaemic clamp carried out on the same subjects showed a correlation of 0.84 (P less than 0.01, N = 12 normal subjects) and 0.65 (P less than 0.001, N = 21 NIDDM patients). We conclude that this modification of the minimal model may improve the number of intravenous glucose tolerance tests capable of systematic analysis in NIDDM subjects, giving a measure of insulin sensitivity that correlates with more established measures of this parameter.