A novel IVGTT model including interstitial insulin

Abstract

Minimal Model (MM) is the top-scoring model for assessing physiological characteristics to diagnose the potential or onset of type 2 diabetes mellitus (T2DM) through the intravenous glucose tolerance test (IVGTT) for the past four decades. Nevertheless it has been arguable that MM method either overestimates glucose effectiveness (GE) or underestimates insulin sensitivity (IS) in some cases by both biologists through in vivo experiments and mathematicians by analysis and/or simulations. We propose a novel model including the interstitial insulin according to physiology and adapted from the well accepted Sturis’ model for the glucose-insulin metabolic system suitable to the IVGTT setting. Our model consistently overcomes the aforementioned defects in a subgroup of subjects. In addition, the variable X for insulin action in MM might be appropriately interpreted as an increment of insulin in the interstitial space in response to the bolus stimulus, rather than being proportional to the interstitial insulin as believed.