The oral glucose minimal model: Estimation of insulin sensitivity from a meal test

Chiara Dalla Man, Andrea Caumo, Claudio Cobelli

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Recently, a new approach has been proposed to estimate insulin sensitivity (S I from an oral glucose tolerance test or a meal using an "integral equation". Here, we improve on the "integral equation" by resorting to a "differential equation" approach. The classic glucose kinetics minimal model was used with the addition of a parametric model for the rate of appearance into plasma of oral glucose (Ra). Three behavioral models of Ra were proposed: piecewise-linear (P), spline (S) and dynamic (D). All three models performed satisfactorily allowing a precise estimation of S I and a plausible reconstruction of Ra. Mean S I estimates were virtually identical: S I P = 6.81 ± 0.87 (SE); S I S = 6.53 ± 0.80; and S I D = 6.62 ± 0.79. S I strongly correlated with the integral-equation index (I) S I I: r = 0.99, p <0.01 for models D and S, and r = 0.97, p <0.01 for P. Also, S I compared well with insulin sensitivity estimated from intravenous glucose tolerance test in the same subjects (r = 0.75, p <0.01; r = 0.71, p <0.01; r = 0.73, p <0.01, respectively, for P, S, and D models versus S IVGTT. Finally, the novel approach allows estimation of S I from a shorter test (120 min): model P yielded S I R = 7.16 ± 1.0 (R for reduced) which correlated very well with S I P and S I I (respectively, r = 0.94, p <0.01; r = 0.95, p <0.01) and still satisfactorily with S I IVGTT (r = 0.77, p <0.01).

Original languageEnglish
Pages (from-to)419-429
Number of pages11
JournalIEEE Transactions on Biomedical Engineering
Issue number5
Publication statusPublished - 2002


  • Glucose kinetics
  • Parameter estimation
  • Physiological model
  • Rate of appearance

ASJC Scopus subject areas

  • Biomedical Engineering


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