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1 Department of Electronics and
Informatics,
Recently, a new
method, based on a two-compartment minimal model and deconvolution
[A. Caumo and C. Cobelli. Am. J. Physiol 264 (Endocrinol.
Metab.. 37): E829-E841, 1993; P. Vicini, G. Sparacino, A. Caumo, and C. Cobelli. Comput. Meth.
Prog. Biomed. 52: 147-156, 1997], has been
proposed to estimate endogenous glucose production (EGP) from labeled
intravenous glucose tolerance test (IVGTT) data. Our aim here is to
compare this EGP profile with that independently obtained with the
reference method, based on the tracer-to-tracee ratio (TTR) clamp. An
insulin-modified (0.03 U/kg body wt infused over 5 min)
[6,6-2H2]glucose-labeled
IVGTT (0.33 g/kg of glucose) was performed in 10 normal subjects. A
second tracer
([U-13C]glucose) was
also infused during the test in a variable fashion to clamp endogenous
glucose TTR. The TTR clamp was quite successful. As a result, the EGP
profile, reconstructed from
[U-13C]glucose data
with the models of Steele and Radziuk, were almost superimposable. The
deconvolution-obtained EGP profile, calculated from
[6,6-2H2]glucose
data, showed remarkable agreement with that obtained from the TTR
clamp. Some differences between the two profiles were noted in the
estimated basal EGP and in the initial modalities of EGP inhibition. A
high interindividual variability was also observed with both methods in
the resumption of EGP to baseline; variability was high in both the
timing and the extent of resumption. In conclusion, the use of the
two-compartment minimal model of the IVGTT and deconvolution allows the
estimation of a profile of EGP that is in very good agreement with that
independently obtained with a TTR clamp.
nonsteady state; mathematical model; tracer-to-tracee ratio; specific activity clamp
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