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Two-Hour Seven-Sample Oral Glucose Tolerance Test and Meal Protocol

Minimal Model Assessment of ß-Cell Responsivity and Insulin Sensitivity in Nondiabetic Individuals

¹ Department of Information Engineering, University of Padova, Padova, Italy
² Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St. Louis, Missouri
³ Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota

Highly informative yet simple protocols to assess insulin secretion and action would considerably enhance the quality of epidemiological and large-scale clinical trials. In an effort to develop such protocols, a 5-h, 11-sample oral glucose tolerance test (OGTT) was performed in 100 individuals and a 7-h, 21-sample meal in another 100. Plasma glucose, insulin, and C-peptide concentrations were measured. We show that virtually the same minimal model assessment of ß-cell responsivity (dynamic [_d] and static [_s]), insulin sensitivity (S_i), and disposition index (DI) can be obtained with a reduced seven-sample 2-h protocol: _d, reduced versus full: 871.50 vs. 873.32, r = 0.98 in OGTT and 494.88 vs. 477.99 10^–9, r = 0.91 in meal; _s: 42.36 vs. 44.35, r = 0.88 in OGTT and 35.31 vs. 35.37 10^–9 min^–1, r = 0.90 in meal; S_i: 24.33 vs. 22.77 10^–5 dl · kg^–1 · min^–1 per pmol/l, r = 0.89 in OGTT and 19.03 vs. 19.77 10^–5 dl · kg^–1 · min^–1 per pmol/l, r = 0.85 in meal; and DI: 1,282.26 vs. 1,273.23, r = 0.84 in OGTT and 726.92 vs. 776.97 10^–14 dl · kg^–1 · min^–2 per pmol/l, r = 0.84 in meal. This reduced protocol will facilitate the study of insulin secretion and action under physiological conditions in nondiabetic humans.

Key Words: AUC, area under the curve • DI, disposition index • OGTT, oral glucose tolerance test

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