Study of Modified Oral Minimal Model using n-Order Decay Rate of Plasma Insulin for the Oral Glucose Tolerance Test in Subjects with Normal, Impaired and Diabetic Glucose Tolerance

Tony Sumaryada,Heriyanto Syafutra,Egha Sabila Putri,Ardian Arif Setiawan,Agus Kartono

doi:10.3844/ajassp.2017.426.435

Abstract

: In this present study, the modified Oral Minimal Model (OMM), with secretion of insulin from pancreas was assumed that the insulin decay rate was not always a ?rst-orderly process in the Oral Glucose Tolerance Test (OGTT), had been developed to study Normal Glucose Tolerance (NGT), Impaired Glucose Tolerance (IGT or pre-diabetes) and type 2 Diabetes Mellitus (T2DM) subjects. The modified OMM model was used to assess physiological functions which were insulin sensitivity (SI) and glucose effectiveness (SG) from the OGTT data. The results of the modified OMM model fit to the measured glucose and insulin concentration-time profiles in the OGTT process of the subjects. The single-step ?tting process to optimize the real pAarameters of the SI and SG index from the experimental data using the modi?ed OMM. Our results showed that all NGT subjects had higher the SI and SG index than all IGT and T2DM subjects following the OGTT process. Basal and large peak glucose were lower in all NGT subjects than in all IGT and T2DM subjects. Insulin extraction was lower in all subjects with T2DM but was almost similar for the NGT and IGT subjects. The averaged correlation between measured and this present model, commonly called R2 value, showed that these four cases were 0.96 which indicated good agreement.

Highlights

Many mathematical models had been proposed for the assessment of the SI and SG index by analyzing glucose tolerance test
We developed a modified Oral Minimal Model (OMM) was used to assess the results of the Normal Glucose Tolerance (NGT), IGT and type 2 Diabetes Mellitus (T2DM) subjects capable of describing the physiological function which occurs during a standard Oral Glucose Tolerance Test (OGTT)
Insulin sensitivity and glucose effectiveness were used in diabetes diagnosis

Summary

Introduction

Many mathematical models had been proposed for the assessment of the SI and SG index by analyzing glucose tolerance test. The most familiar of these models was the classical minimal model proposed by Bergman et al (1979), which analyses an Intravenous Glucose Tolerance Test (IVGTT) to optimize the SI and SG index. The model composed two coupled ordinary differential equations: One modeling the rate of glucose clearance based on the action of the remote insulin and the other giving the rate of a secretion of the remote insulin compartment. These mechanisms could help ameliorate the effects of noise in the glucose or insulin measures during the IVGTT on the calculated SI and SG index. The IVGTT process was not highly recommended to have a method able to quantify the SI and SG index in a normal life (Dalla Man et al, 2004; Claudio et al, 2014)

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