Quon M J, Cochran C, Taylor S I, Eastman R C
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892.
Diabetes. 1994 Jul;43(7):890-6. doi: 10.2337/diab.43.7.890.
Both insulin and glucose contribute to the regulation of glucose metabolism in vivo. We directly measured the ability of glucose per se to promote glucose disposal in subjects with insulin-dependent diabetes mellitus (IDDM). We compared our results with predictions of the minimal model of glucose metabolism. To identify minimal model parameters, a frequently sampled intravenous glucose tolerance test (FSIVGTT) was administered to each subject while they were connected to a Biostator (a device that monitors blood glucose and gives insulin to mimic normal insulin secretion). Data from this test reflected normal glucose tolerance and were in excellent agreement with minimal model predictions. The FSIVGTT was then repeated without the Biostator in the same diabetic subjects in order to directly measure the effect of glucose per se to promote glucose disposal in the absence of an incremental insulin effect (a basal insulin drip was maintained). To compare these results with minimal model predictions, the equations describing glucose disappearance in the absence of an incremental insulin effect were solved using parameters identified from the Biostator experiment. The glucose disappearance measured in the absence of an incremental insulin response was much slower than the minimal model predictions. Thus, the minimal model appears to overestimate the effect of glucose per se on glucose uptake and underestimate the contribution of incremental insulin.
胰岛素和葡萄糖都参与体内葡萄糖代谢的调节。我们直接测定了葡萄糖本身在胰岛素依赖型糖尿病（IDDM）患者中促进葡萄糖清除的能力。我们将结果与葡萄糖代谢最小模型的预测值进行了比较。为了确定最小模型参数，在每位受试者连接到生物人工肝装置（一种监测血糖并给予胰岛素以模拟正常胰岛素分泌的设备）时，对其进行了频繁采样的静脉葡萄糖耐量试验（FSIVGTT）。该试验数据反映了正常的葡萄糖耐量，并且与最小模型预测值高度吻合。然后，在相同的糖尿病患者中，在不使用生物人工肝装置的情况下重复进行FSIVGTT，以直接测量在没有胰岛素增量效应（维持基础胰岛素滴注）的情况下葡萄糖本身促进葡萄糖清除的作用。为了将这些结果与最小模型预测值进行比较，使用从生物人工肝装置实验中确定的参数求解了描述在没有胰岛素增量效应时葡萄糖消失的方程。在没有胰岛素增量反应的情况下测得的葡萄糖消失速度比最小模型预测值慢得多。因此，最小模型似乎高估了葡萄糖本身对葡萄糖摄取的影响，而低估了胰岛素增量的作用。
