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In order to provide a method for precise identification of insulin sensitivity from clinical Oral Glucose Tolerance Test (OGTT) observations, a relatively simple mathematical model (Simple Interdependent glucose/insulin MOdel SIMO) for the OGTT, which coherently incorporates commonly accepted physiological assumptions (incretin effect and saturating glucose-driven insulin secretion) has been developed. OGTT data from 78 patients in five different glucose tolerance groups were analyzed: normal glucose tolerance (NGT), impaired glucose tolerance (IGT), impaired fasting glucose (IFG), IFG+IGT, and Type 2 Diabetes Mellitus (T2DM). A comparison with the 2011 Salinari (COntinuos GI tract MOdel, COMO) and the 2002 Dalla Man (Dalla Man MOdel, DMMO) models was made with particular attention to insulin sensitivity indices IS COMO , IS DMMO  and  k xgi   (the insulin sensitivity index for SIMO). ANOVA on  k xgi   values across groups resulted significant overall (P<0.001), and post-hoc comparisons highlighted the presence of three different groups: NGT (8.62×10 −5 ±9.36×10 −5  min −1 pM −1 ), IFG (5.30×10 −5 ±5.18×10 −5 ) and combined IGT, IFG+IGT and T2DM (2.09×10 −5 ±1.95×10 −5 , 2.38×10 −5 ±2.28×10 −5  and 2.38×10 −5 ±2.09×10 −5  respectively). No significance was obtained when comparing IS COMO  or IS DMMO  across groups. Moreover,  k xgi   presented the lowest sample average coefficient of variation over the five groups (25.43%), with average CVs for IS COMO  and IS DMMO  of 70.32% and 57.75% respectively;  k xgi   also presented the strongest correlations with all considered empirical measures of insulin sensitivity. While COMO and DMMO appear over-parameterized for fitting single-subject clinical OGTT data, SIMO provides a robust, precise, physiologically plausible estimate of insulin sensitivity, with which habitual empirical insulin sensitivity indices correlate well. The  k xgi   index, reflecting insulin secretion dependency on glycemia, also significantly differentiates clinically diverse subject groups. The SIMO model may therefore be of value for the quantification of glucose homeostasis from clinical OGTT data.

Routine OGTT: A Robust Model Including Incretin Effect for Precise Identification of Insulin Sensitivity and Secretion in a Single Individual