Diabetes Metab J.  2016 Aug;40(4):308-317. 10.4093/dmj.2016.40.4.308.

Application of the Oral Minimal Model to Korean Subjects with Normal Glucose Tolerance and Type 2 Diabetes Mellitus

• Lim MH
• Oh TJ
• Choi K
• Lee JC
• Cho YM
• Kim S

• KMID: 2368518
• DOI: http://doi.org/10.4093/dmj.2016.40.4.308

Abstract

BACKGROUND
The oral minimal model is a simple, useful tool for the assessment of β-cell function and insulin sensitivity across the spectrum of glucose tolerance, including normal glucose tolerance (NGT), prediabetes, and type 2 diabetes mellitus (T2DM) in humans.
METHODS
Plasma glucose, insulin, and C-peptide levels were measured during a 180-minute, 75-g oral glucose tolerance test in 24 Korean subjects with NGT (n=10) and T2DM (n=14). The parameters in the computational model were estimated, and the indexes for insulin sensitivity and β-cell function were compared between the NGT and T2DM groups.
RESULTS
The insulin sensitivity index was lower in the T2DM group than the NGT group. The basal index of β-cell responsivity, basal hepatic insulin extraction ratio, and post-glucose challenge hepatic insulin extraction ratio were not different between the NGT and T2DM groups. The dynamic, static, and total β-cell responsivity indexes were significantly lower in the T2DM group than the NGT group. The dynamic, static, and total disposition indexes were also significantly lower in the T2DM group than the NGT group.
CONCLUSION
The oral minimal model can be reproducibly applied to evaluate β-cell function and insulin sensitivity in Koreans.

Keyword

Computational method; Disposition index; Glucose tolerance test; Insulin resistance; Oral minimal model; Responsivity index

MeSH Terms

Blood Glucose
C-Peptide
Diabetes Mellitus, Type 2*
Glucose Tolerance Test
Glucose*
Humans
Insulin
Insulin Resistance
Prediabetic State
C-Peptide
Glucose
Insulin

Figure

• 

  Fig. 1 The indexes for (A) insulin sensitivity (SI) and (B) basal, (C) dynamic, (D) static and (E) total β-cell responsivity (Φb, Φd, Φs, and Φt), (F) basal hepatic insulin extraction ratio (HEb), and (G) post-glucose challenge hepatic insulin extraction ratio (HEpost). The Mann-Whitney test was used to compare the indexes between the groups. NGT, normal glucose tolerance; T2DM, type 2 diabetes mellitus; NS, not significant.

• 

  Fig. 2 The (A) dynamic, (B) static, and (C) total disposition indexes (DId, DIs, and DIt) in the patients with type 2 diabetes mellitus (T2DM) and individuals with normal glucose tolerance (NGT). The Mann-Whitney test was used to compare the indexes between the groups.

• 

  Fig. 3 Distribution of insulin sensitivity and secretion in the patients with type 2 diabetes (T2DM) and individuals with normal glucose tolerance (NGT). The hyperbolae for the (A) dynamic, (B) static, (C) and total disposition (DIs, DId, and DIt) indexes are shown for the NGT group (black line and open black circles) and the T2DM group (gray line and open gray circles) with a DI metric. Each circle or square represents a single subject. The subjects in each group presumably share the same disposition index, and a tendency toward the leftward and downward positioning in the T2DM patients can be observed. Φd, dynamic; Φs, static; Φt, total β-cell responsivity.

• 

  Fig. 4 Correlation analyses between the indexes obtained in the oral minimal model and other indexes of insulin secretion or insulin sensitivity (SI). Spearman correlation analysis was used. Correlations of (A) dynamic (Φd) and (B) static β-cell responsivity (Φs) with postprandial C-peptide to glucose ratio (PCGR) are shown. Correlations of insulin sensitivity (SI) with (C) Matsuda index and (D) homeostasis model assessment of insulin resistance (HOMA-IR) are shown.

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