Optimal design of sampling schedules for studying glucose kinetics with tracers

Minimum size sampling schedules for estimating glucose kinetic parameters from an impulsive (bolus) tracer injection in normal humans and rats are presented. Glucose kinetics are described by a two-compartment linear model, and reference values of the parameters are estimated from a data base with many samples. The optimal sampling schedule (OSS) is determined in each individual by using a D-optimal criterion and consists of four samples. A population optimal sampling schedule (POSS) applicable to all the individuals of a given population is then determined, and its reliability and efficiency in recovering kinetic parameters (e.g., rate constants, plasma clearance rate, and mean residence time) is assessed. The influence of model and measurement error on OSS is discussed. Moreover, the adoption of an enhanced POSS (EPOSS, 8 samples) is shown to improve accuracy and precision of parameter estimates in a predictable manner. Finally some suggestions are given for obtaining more information from turnover studies using a constant infusion of tracer, with or without a priming pulse of tracer.