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DDMODEL00000227: Glucose kinetics in humans: a unique model for different tests

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This is a model for glucose kinetics in humans, including a physiology-based mechanism for glucose uptake saturation. It is able to describe the relationship between glucose utilization and glucose and insulin concentrations during different tests, such as the clamp, the oral glucose tolerance test and the mixed-meal test.
PharmML 0.8.x (0.8.1)
  • Glucose uptake saturation explains glucose kinetics profiles measured by different tests.
  • Bizzotto R, Natali A, Gastaldelli A, Muscelli E, Krssak M, Brehm A, Roden M, Ferrannini E, Mari A
  • American journal of physiology. Endocrinology and metabolism, 8/2016, Volume 311, Issue 2, pages: E346-57
  • CNR Institute of Neuroscience, Padua, Italy; roberto.bizzotto@isib.cnr.it.
  • It is known that for a given insulin level glucose clearance depends on glucose concentration. However, a quantitative representation of the concomitant effects of hyperinsulinemia and hyperglycemia on glucose clearance, necessary to describe heterogeneous tests such as euglycemic and hyperglycemic clamps and oral tests, is lacking. Data from five studies (123 subjects) using a glucose tracer and including all the above tests in normal and diabetic subjects were collected. A mathematical model was developed in which glucose utilization was represented as a Michaelis-Menten function of glucose with constant Km and insulin-controlled Vmax, consistently with the basic notions of glucose transport. Individual values for the model parameters were estimated using a population approach. Tracer data were accurately fitted in all tests. The estimated Km was 3.88 (2.83-5.32) mmol/l [median (interquartile range)]. Median model-derived glucose clearance at 600 pmol/l insulin was reduced from 246 to 158 ml·min(-1)·m(-2) when glucose was raised from 5 to 10 mmol/l. The model reproduced the characteristic lack of increase in glucose clearance when moderate hyperinsulinemia was accompanied by hyperglycemia. In all tests, insulin sensitivity was inversely correlated with BMI, as expected (R(2) = 0.234, P = 0.0001). In conclusion, glucose clearance in euglycemic and hyperglycemic clamps and oral tests can be described with a unifying model, consistent with the notions of glucose transport and able to reproduce the suppression of glucose clearance due to hyperglycemia observed in previous studies. The model may be important for the design of reliable glucose homeostasis simulators.
Roberto Bizzotto
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  • Model owner: Roberto Bizzotto
  • Submitted: Oct 14, 2016 5:54:08 PM
  • Last Modified: Jun 30, 2017 8:02:50 AM
Revisions
  • Version: 15 public model Download this version
    • Submitted on: Jun 30, 2017 8:02:50 AM
    • Submitted by: Roberto Bizzotto
    • With comment: Edited model metadata online.
  • Version: 13 public model Download this version
    • Submitted on: Oct 14, 2016 6:12:56 PM
    • Submitted by: Roberto Bizzotto
    • With comment: Edited model metadata online.
  • Version: 11 public model Download this version
    • Submitted on: Oct 14, 2016 6:05:42 PM
    • Submitted by: Roberto Bizzotto
    • With comment: Edited model metadata online.
  • Version: 9 public model Download this version
    • Submitted on: Oct 14, 2016 5:54:08 PM
    • Submitted by: Roberto Bizzotto
    • With comment: Edited model metadata online.
 
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