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Tipo di prodottoArticolo in rivista
TitoloModeling glucose and free fatty acid kinetics during insulin-modified intravenous glucose tolerance test in healthy humans: Role of counterregulatory response
Anno di pubblicazione2014
Autore/iThomaseth K.; Brehm A.; Pavan A.; Pacini G.; Roden M.
Affiliazioni autoriInstitute of Biomedical Engineering, National Research Council, Padua, Italy; Karl-Landsteiner Institute for Endocrinology and Metabolism at 1st Medical Department, Hanusch Hospital, Vienna, Austria; Department of Endocrinology and Diabetology, University Hospital, Düsseldorf, Germany; German Center for Diabetes Research, Düsseldorf, Germany
Autori CNR e affiliazioni
  • inglese
AbstractInsulin administration during insulin-modified intravenous glucose tolerance test (IM-IVGTT) can induce transient hypoglycemia in healthy insulin-sensitive subjects. This triggers counterregulatory reflex (CRR) responses, which influence the kinetics of glucose and nonesterified fatty acids (NEFA), and undermines the accuracy of mathematical modeling methods that do not explicitly account for CRR. The aim of this study is to evaluate mathematical models of glucose and NEFA kinetics against experimental data in the presence or absence of CRR. Thirteen healthy nondiabetic subjects underwent a standard IM-IVGTT and a modified test (GC-IM-IVGTT) with a variable glucose infusion preventing hypoglycemia. While model predictions fit very well with glucose and NEFA data from GC-IM-IVGTT, they lagged behind observations from IM-IVGTT during recovery from hypoglycemia, independently of insulinemia, which did not differ significantly between protocols. A modification to the glucose minimal model, using the glucose concentration below a threshold as a signal for CRR, improves model predictions for both glucose and NEFA. The associated increase in endogenous glucose production correlates, among various CRR hormones, mainly with the dynamics of glucagon concentration. The modified minimal models introduce new parameters that quantify strength and duration of CRR following hypoglycemia. Although CRR represents an unwanted side-effect in IM-IVGTT occurring only in insulin-sensitive subjects, this study provides new insights leading to improved procedures for estimating insulin sensitivity from IM-IVGTT, which may also allow for assessing the individual capacity of recovery from hypoglycemic events in patients treated with insulin or insulin-releasing drugs. © 2014 the American Physiological Society.
Lingua abstractinglese
Altro abstract-
Lingua altro abstract-
Pagine daR321
Pagine aR331
Pagine totali-
RivistaAmerican journal of physiology. Regulatory, integrative and comparative physiology
Attiva dal 1977 al 2011
Editore: American Physiological Society. - [Bethesda, Md.]
Paese di pubblicazione: Stati Uniti d'America
Lingua: inglese
ISSN: 0363-6119
Titolo chiave: American journal of physiology. Regulatory, integrative and comparative physiology
Titolo proprio: American journal of physiology
Titolo abbreviato: Am. j. physiol., Regul. integr. comp. physiol.
Titoli alternativi:
  • Regulatory, integrative and comparative physiology
  • AJP:
  • regulatory, integrative and comparative physiology
Numero volume della rivista307
Fascicolo della rivista3
Verificato da refereeSì: Internazionale
Stato della pubblicazione-
Indicizzazione (in banche dati controllate)
  • Scopus (Codice:2-s2.0-84905215895)
  • ISI Web of Science (WOS) (Codice:000340833300009)
Parole chiaveHypoglycemia, Insulin sensitivity, Mathematical modeling, Nonesterified fatty acids
Link (URL, URI)
Titolo parallelo-
Data di accettazione-
Note/Altre informazioni-
Strutture CNR
  • IEIIT — Istituto di elettronica e di ingegneria dell'informazione e delle telecomunicazioni
  • ISIB — Istituto di ingegneria biomedica
  • IN — IN - Sede secondaria di Padova
Moduli CNR
  • ME.P06.016.001 : Metodi e modelli matematici per la ricerca clinica sul metabolismo, il diabete e sue complicanze
Progetti Europei-
Modeling glucose and free fatty acid kinetics during insulin-modified intravenous glucose tolerance test in healthy humans (documento privato )
Tipo documento: application/pdf