Abstract
Background and objectiveThe oral minimal model (OMM) of glucose dynamics is a prominent method for assessing postprandial glucose metabolism. The model yields estimates of insulin sensitivity and the meal-related appearance of glucose from insulin and glucose data after an oral glucose challenge. Despite its success, the OMM approach has several weaknesses that this paper addresses. MethodsA novel procedure introducing three methodological adaptations to the OMM approach is proposed. These are: (1) the use of a fully Bayesian and efficient method for parameter estimation, (2) the model identification from non-fasting conditions using a generalised model formulation and (3) the introduction of a novel function to represent the meal-related glucose appearance based on two superimposed components utilising a modified structure of the log-normal distribution. The proposed modelling procedure is applied to glucose and insulin data from subjects with normal glucose tolerance consuming three consecutive meals in intervals of four hours. ResultsIt is shown that the glucose effectiveness parameter of the OMM is, contrary to previous results, structurally globally identifiable. In comparison to results from existing studies that use the conventional identification procedure, the proposed approach yields an equivalent level of model fit and a similar precision of insulin sensitivity estimates. Furthermore, the new procedure shows no deterioration of model fit when data from non-fasting conditions are used. In comparison to the conventional, piecewise linear function of glucose appearance, the novel log-normally based function provides an improved model fit in the first 30 min of the response and thus a more realistic estimation of glucose appearance during this period. The identification procedure is implemented in freely accesible MATLAB and Python software packages. ConclusionsWe propose an improved and freely available method for the identification of the OMM which could become the future standardard for the oral minimal modelling method of glucose dynamics.
Highlights
The quantitative assessment of the body’s response to food intake in people with normal and impaired glucose tolerance is crucial in the development of therapeutic strategies for dia-(GA) in the peripheral bloodstream [9]
It was concluded that the oral minimal model (OMM) is a reliable tool to estimate both insulin sensitivity and glucose appearance during OGTTs and MTTs
The OMM was proposed in 2002 by Dalla Man et al [9] and is based on an earlier model often referred to as minimal model, which was developed for the description of glucose excursions during an intravenous glucose tolerance test (IVGTT) [12]
Summary
The quantitative assessment of the body’s response to food intake in people with normal and impaired glucose tolerance is crucial in the development of therapeutic strategies for dia-(GA) in the peripheral bloodstream [9]. The OMM has been extensively validated against data from experiments using traced glucose [10] as well as traced glucose and clamp measurements [11] In both studies, it was concluded that the OMM is a reliable tool to estimate both insulin sensitivity and glucose appearance during OGTTs and MTTs. The OMM was proposed in 2002 by Dalla Man et al [9] and is based on an earlier model often referred to as minimal model, which was developed for the description of glucose excursions during an intravenous glucose tolerance test (IVGTT) [12]. Despite the OMM’s success in assessing postprandial glucose metabolism, the conventional modelling approach using the OMM has several weaknesses that this paper will address. The OMM approach has several weaknesses that this paper addresses
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
