Dynamic insulin sensitivity index: importance in diabetes.

American Journal of Physiology. Endocrinology and Metabolism
Gianluigi PillonettoC Cobelli

Abstract

The classical minimal model (MM) index of insulin sensitivity, S(I), does not account for how fast or slow insulin action takes place. In a recent work, we proposed a new dynamic insulin sensitivity index, S(I)(D), which is able to take into account the dynamics of insulin action as well. The new index is a function of two MM parameters, namely S(I) and p(2), the latter parameter governing the speed of rise and decay of insulin action. We have previously shown that in normal glucose tolerant subjects S(I)(D) provides a more comprehensive picture of insulin action on glucose metabolism than S(I). The aim of this study is to show that resorting to S(I)(D) rather S(I) is even more appropriate when studying diabetic patients who have a low and slow insulin action. We analyzed insulin-modified intravenous glucose tolerance test studies performed in 10 diabetic subjects and mixed meal glucose tolerance test studies exploiting the triple tracer technique in 14 diabetic subjects. We derived both S(I) and S(I)(D) resorting to Bayesian and Fisherian identification strategies. The results show that S(I)(D) is estimated more precisely than S(I) when using the Bayesian approach. In addition, the less labor-intensive Fisherian approach can s...Continue Reading

References

Jun 1, 1979·The American Journal of Physiology·R N BergmanC Cobelli
Nov 1, 1981·Metabolism: Clinical and Experimental·R M KliegmanP A Adam
Apr 29, 1998·Metabolism: Clinical and Experimental·P H BarrettD M Foster
Feb 8, 2002·American Journal of Physiology. Endocrinology and Metabolism·Gianluigi PillonettoClaudio Cobelli
May 11, 2002·IEEE Transactions on Bio-medical Engineering·Chiara Dalla ManClaudio Cobelli
Jul 15, 2005·American Journal of Physiology. Endocrinology and Metabolism·Chiara Dalla ManClaudio Cobelli
Mar 15, 2006·IEEE Transactions on Bio-medical Engineering·Gianluigi PillonettoClaudio Cobelli

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Citations

Mar 31, 2011·Medical & Biological Engineering & Computing·Roberto BurattiniMassimo Boemi
Aug 14, 2012·Gastroenterology·David BradleySamuel Klein
Mar 22, 2014·Diabetes·Claudio CobelliRobert Rizza

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