Models of glucose disposal: estimation of glucose effectiveness with an optimal protocol

摘要

In this study the authors developed models to describe the effect of glucose on its own disposal (glucose effectiveness) under nonsteady state conditions. The database consisted of experiments during which glucose concentration exhibited a meal-like profile while insulin was maintained at the basal level. This optimal protocol allowed the authors to rule out the possibly confounding effect of hyperinsulinemia on the assessment of glucose effectiveness. Five models were formulated. All were based upon a monocompartmental description of glucose kinetics but used different descriptions of the rate of glucose uptake as a function of glucose concentration. The two models which appeared superior in terms of model fit and precision of the parameter estimates incorporate a nonlinear, saturative effect of hyperglycemia and a delay between glucose elevation in plasma and its effect on glucose uptake.