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Honda M, Tsuboi A, Minato-Inokawa S, Kitaoka K, Takeuchi M, Yano M, Kurata M, Wu B, Kazumi T, Fukuo K. Association of family history of type 2 diabetes with blood pressure and resting heart rate in young normal weight Japanese women. Diabetol Int 2021; 13:220-225. [DOI: 10.1007/s13340-021-00525-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/20/2021] [Indexed: 12/14/2022]
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Murai N, Saito N, Kodama E, Iida T, Mikura K, Imai H, Kaji M, Hashizume M, Kigawa Y, Koizumi G, Tadokoro R, Sugisawa C, Endo K, Iizaka T, Saiki R, Otsuka F, Ishibashi S, Nagasaka S. Glucose Effectiveness Decreases in Relationship to a Subtle Worsening of Metabolic Parameters in Young Japanese with Normal Glucose Tolerance. Metab Syndr Relat Disord 2021; 19:409-415. [PMID: 34190620 DOI: 10.1089/met.2021.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The aim of the study was to investigate the relationship between glucose effectiveness (Sg) and some metabolic parameters in male and female young Japanese. Methods: We measured plasma glucose and immunoreactive insulin levels in 1309 young Japanese persons (age <40 years) with normal glucose tolerance (NGT) before and at 30, 60, and 120 min during a 75 gram oral glucose tolerance test. We also measured serum adiponectin and high-sensitivity C-reactive protein (hsCRP) levels and oral glucose effectiveness (SgIO), and investigated factors related to SgIO. Results: The results of Spearman correlation analysis revealed that high-density lipoprotein cholesterol (HDL) and adiponectin were positively correlated with SgIO, whereas the proportion of males, body mass index, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure, triglycerides (TG), and hsCRP were inversely correlated with SgIO. The results of multiple regression analysis indicated negative correlations between SgIO and the proportion of males, WC, and SBP and a positive correlation with HDL. The results of multiple regression analysis excluding WC indicated negative correlations between SgIO and the proportion of males, SBP, and TG and positive correlations with HDL and adiponectin. Conclusions: Sg decreased with a subtle worsening of metabolic parameters, even in young persons with NGT. Decreased Sg may be involved in the development of glucose intolerance in individuals with worse metabolic parameters.
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Affiliation(s)
- Norimitsu Murai
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Naoko Saito
- Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Eriko Kodama
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Tatsuya Iida
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Kentaro Mikura
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Hideyuki Imai
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Mariko Kaji
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Mai Hashizume
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Yasuyoshi Kigawa
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Go Koizumi
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Rie Tadokoro
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Chiho Sugisawa
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Kei Endo
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Toru Iizaka
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Ryo Saiki
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Fumiko Otsuka
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Shoichiro Nagasaka
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan.,Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Tochigi, Japan
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Ahrén B, Pacini G. Glucose effectiveness: Lessons from studies on insulin-independent glucose clearance in mice. J Diabetes Investig 2021; 12:675-685. [PMID: 33098240 PMCID: PMC8088998 DOI: 10.1111/jdi.13446] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/15/2020] [Accepted: 10/19/2020] [Indexed: 01/07/2023] Open
Abstract
Besides insulin-mediated transport of glucose into the cells, an important role is also played by the non-insulin-mediated transport. This latter process is called glucose effectiveness (acronym SG ), which is estimated by modeling of glucose and insulin data after an intravenous glucose administration, and accounts for ≈70% of glucose disposal. This review summarizes studies on SG , mainly in humans and rodents with focus on results achieved in model experiments in mice. In humans, SG is reduced in type 2 diabetes, in obesity, in liver cirrhosis and in some elderly populations. In model experiments in mice, SG is independent from glucose levels, but increases when insulin secretion is stimulated, such as after administration of the incretin hormones, glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide. SG is reduced in insulin resistance induced by high-fat feeding and by exogenous administration of glucagon. Glucose-dependent (insulin-independent) glucose disposal is therefore important for glucose elimination, and it is also well regulated. It might be of pathophysiological relevance for the development of type 2 diabetes, in particular during insulin resistance, and might also be a target for glucose-reducing therapy. Measuring SG is essentially important when carrying out metabolic studies to understand glucose homeostasis.
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Affiliation(s)
- Bo Ahrén
- Department of Clinical Sciences LundLund UniversityLundSweden
| | - Giovanni Pacini
- Metabolic UnitInstitute of Neurosciences (IN‐CNR)PadovaItaly
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Takeuchi M, Wu B, Honda M, Tsuboi A, Kitaoka K, Minato S, Kurata M, Kazumi T, Fukuo K. Decreased arterial distensibility and postmeal hyperinsulinemia in young Japanese women with family history of diabetes. BMJ Open Diabetes Res Care 2020; 8:8/1/e001244. [PMID: 32371532 PMCID: PMC7228472 DOI: 10.1136/bmjdrc-2020-001244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/09/2020] [Accepted: 04/14/2020] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION To assess vascular function and characterize insulin secretion using a physiological approach in Japanese women with family history of type 2 diabetes (FHD). RESEARCH DESIGN AND METHODS Standardized mixed-meal tests were performed with multiple postprandial glucose, insulin and free fatty acids (FFA) measurements over a 30-120 min period in 31 Japanese women aged 21-24 years. Arterial distensibility was assessed as well. RESULTS Fasting glucose, triglyceride and insulin averaged <90 mg/dL, <60 mg/dL and <5 μU/mL, respectively, and did not differ cross-sectionally between 10 with (FHD+) and 21 without FHD (FHD-). FHD+ showed higher insulin responses not only during the first 30 min (p=0.005) but also during the second hour (60-120 min, p<0,05) in spite of identical postprandial suppression of FFA and identical fasting and postprandial glucose and FFA concentrations, except for higher 60 min FFA in FHD+. Further, FHD+ had decreased arterial distensibility (p=0.003). On multivariate regression analysis, arterial distensibility emerged as the only significant independent predictor of FHD+. Endurance training in FHD+ did not alter decreased arterial distensibility whereas it abolished postprandial hyperinsulinemia. CONCLUSIONS FHD was associated with decreased arterial distensibility and postprandial hyperinsulinemia despite nearly identical postprandial glycemia and postprandial FFA suppression, suggesting that impaired vascular insulin sensitivity may precede glucose and lipid dysmetabolism in normal weight Japanese women aged 22 years.
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Affiliation(s)
- Mika Takeuchi
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Japan
| | - Bin Wu
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Japan
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Mari Honda
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Japan
- Department of Health, Sports, and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Kobe, Japan
| | - Ayaka Tsuboi
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Japan
- Department of Nutrition, Osaka City Juso Hospital, Osaka, Japan
| | - Kaori Kitaoka
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Japan
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Satomi Minato
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Japan
- Graduate School of Human Science and Environment, University of Hyogo, Himeji, Japan
| | - Miki Kurata
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Japan
- Department of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Japan
| | - Tsutomu Kazumi
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Japan
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Japan
- Department of Medicine, Kohnan Kakogawa Hospital, Kakogawa, Japan
| | - Keisuke Fukuo
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Japan
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Japan
- Department of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Japan
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Honda M, Tsuboi A, Minato-Inokawa S, Kitaoka K, Takeuchi M, Yano M, Kurata M, Wu B, Kazumi T, Fukuo K. Reduced Birth Weight, Decreased Early-Phase Insulin Secretion, and Increased Glucose Concentrations after Oral Glucose Tolerance Test in Japanese Women Aged 20 Years with Family History of Type 2 Diabetes. J Diabetes Res 2020; 2020:8822135. [PMID: 33490284 PMCID: PMC7787832 DOI: 10.1155/2020/8822135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/30/2020] [Accepted: 12/04/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION We tested the hypothesis that family history of type 2 diabetes (FHD) is associated with reduced birth weight and reduced insulin secretion later in life. MATERIALS AND METHODS Birth weight, body composition by whole-body dual-energy X-ray absorptiometry, and homeostasis model assessment-insulin resistance were compared between Japanese women aged 20 years with positive (n = 73) and negative (n = 258) FHD. A subsample of 153 women (57 with positive FHD) underwent a 75 g oral glucose tolerance test. Multivariate logistic regression analyses were used to identify the most important determinants of FHD. RESULTS Women with positive as compared with negative FHD had lower birth weight (3132 ± 364 vs. 3238 ± 418 g, p = 0.04). However, the current fat mass index and trunk/leg fat ratio, sophisticated measures of general and abdominal fat accumulation, respectively, did not differ. Women with positive FHD had a lower insulinogenic index (2.4 ± 7.3 vs. 6.2 ± 16, p = 0.007) and higher area under the glucose curve (217 ± 47 vs. 198 ± 36 mg/dL/2 h, p = 0.006). However, fasting and postload insulinemia, homeostasis model assessment-insulin resistance, and Matsuda index did not differ. In multivariate logistic regression analysis, birth weight was marginally associated with FHD (odds ratio, 0.999; 95% confidential interval, 0.98-1.00000; p = 0.0509). CONCLUSIONS FHD was associated not only with reduced birth weight but also with decreased early-phase insulin secretion and increased postload glucose concentrations in Japanese women aged 20 years. These findings may be in keeping with the fetal insulin hypothesis and provide some evidence that FHD can alter size at birth, probably through genetic and shared environmental components, which consequently resulted in decreased early-phase insulin secretion and increased glucose excursion in the early twenties. FHD was not related to sophisticated measures of general and abdominal adiposity and insulin resistance/sensitivity.
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Affiliation(s)
- Mari Honda
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Health, Sports, and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Kobe, Hyogo, Japan
| | - Ayaka Tsuboi
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Nutrition, Osaka City Juso Hospital, Osaka, Japan
| | - Satomi Minato-Inokawa
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Laboratory of Community Health and Nutrition, Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Ehime, Japan
| | - Kaori Kitaoka
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Mika Takeuchi
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Megumu Yano
- Department of Food Sciences and Nutrition, School of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Miki Kurata
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Food Sciences and Nutrition, School of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Bin Wu
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Tsutomu Kazumi
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Medicine, Kohnan Kakogawa Hospital, Kakogawa, Hyogo, Japan
| | - Keisuke Fukuo
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Food Sciences and Nutrition, School of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
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Osei K, Gaillard T. Pathogenic Mechanisms of Prediabetes in Obese vs. Very Obese African American Women: Implications for Diabetes Prevention. J Natl Med Assoc 2019; 111:76-82. [PMID: 30032866 DOI: 10.1016/j.jnma.2018.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 06/14/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND The influence of obesity on the development of prediabetes among African American women (AAW) remains uncertain. Thus, we investigated whether the pathogenic mechanisms of prediabetes differ in obese (OB, BMI<35 kg/m2) and very obese (VOB, BMI>35 kg/m2) AAW. SUBJECTS/METHODS We recruited 26-OB and 41-VOB, AAW with prediabetes, mean age (46.3 ± 10.3 years), A1C (5.9 ± 0.4%) and BMI (38.3 ± 8.2 kg/m2). OGTT and FSIVGT were performed in each subject. Body composition (% body fat) was measured using DEXA. Si, Sg acute insulin response to glucose (AIRg) and disposition index (DI) were calculated using minimal model method. RESULTS Mean BMI (32.6 ± 1.9 vs. 42.8 ± 5.5 kg/m2) and %body fat (44.7 ± 2.0 vs. 49.6 ± 2.2%) were significantly (p = 0.0001) lower in OB vs VOB. Mean fasting and post-glucose challenge, (glucose, insulin, c-peptide) levels were significantly (p = 0.03-0.0001) lower in OB vs VOB. Mean Si and Sg was not different. Mean AIRg tended to be higher (808 ± 776 vs. 535 ± 443 (x min [uU/L] -1), p = 0.106) whereas DI was greater (1999 ± 1408 vs. 1511 ± 1033, (×10-2 x min-1), p = 0.01) in OB vs VOB subjects. CONCLUSION We found that OB and VOB AAW had similar Si and Sg, but VOB showed attenuated AIRg and DI. These parameters should be considered when developing primary prevention programs in AAW with prediabetes.
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Affiliation(s)
- Kwame Osei
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University Wexner Medical Center, 561 McCampbell Hall (5 South), 1581 Dodd Drive, Columbus, OH, 43210, USA.
| | - Trudy Gaillard
- Nicole Wertheim College of Nursing & Health Sciences, Florida International University, 11200 SW 8(th) St., AHC3 534A, Miami, FL 33199, USA
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Osei K, Gaillard T. Ethnic differences in glucose effectiveness and disposition index in overweight/obese African American and white women with prediabetes: A study of compensatory mechanisms. Diabetes Res Clin Pract 2017. [PMID: 28629856 DOI: 10.1016/j.diabres.2017.02.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Prediabetes, a major precursor of type 2 diabetes, varies among ethnic populations. Therefore, we compared the pathophysiologic mechanisms of prediabetes in overweight/obese African American (AA) and White American (WA) women. SUBJECTS AND METHODS We recruited 95 women (67 AA, 28 WA) with prediabetes. Standard OGTT and FSIVGTT were performed in each subject. Insulin sensitivity (Si), glucose effectiveness (Sg), beta cell function (acute insulin response to glucose (AIRg) and disposition index (DI: Si×AIRg) were calculated using Bergman's Minmod. RESULTS Mean BMI was greater in AA vs WA with prediabetes (38.3±8.2vs 34.6±8.5kg/m2, p=0.05). Mean fasting serum glucose, and insulin levels were lower in AA vs WA. Similarly, mean peak serum glucose levels were lower while peak insulin levels were higher at 30 and 60minutes in AA vs WA. In contrast, mean fasting and peak serum c-peptide levels at 60 and 90minutes were significantly lower in AA vs WA. Mean AIRg was higher but not significantly different in AA vs WA (633±520.92 vs 414.8±246.8, p=0.193). Although, Si (2.93±3.25vs 44 2.50±1.76 (×10-4×min-1 [μU/ml]-1), p=0.448) was not different, DI was significantly higher in AA vs WA (1381±1126 vs 901.9±477.1, p=0.01). In addition, mean Sg was significantly higher in AAvs WA (2.51±1.17 vs 1.97±0.723 (×10-2/min), p=0.02). CONCLUSIONS We found that in overweight/obese prediabetic AA and WA women with similar Si, the mean Sg and DI were significantly higher in AA. We conclude that the pathophysiologic mechanisms of prediabetes differ in the overweight/obese AA and WA women.
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Affiliation(s)
- Kwame Osei
- Division of Endocrinology, Diabetes and Metabolism and Diabetes Research Center, The Ohio State University Wexner Medical Center, 561 Mccampbell Hall (5 South), 1581 Dodd Drive, Columbus, OH 43210, United States.
| | - Trudy Gaillard
- University of Cincinnati, College of Nursing, Procter Hall #230, 3110 Vine Street, PO Box 210038, Cincinnati, OH 45221-0038, United States.
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Dube S, Errazuriz-Cruzat I, Basu A, Basu R. The forgotten role of glucose effectiveness in the regulation of glucose tolerance. Curr Diab Rep 2015; 15:605. [PMID: 25869240 DOI: 10.1007/s11892-015-0605-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Glucose effectiveness (SG) is the ability of glucose per se to stimulate its own uptake and to suppress its own production under basal/constant insulin concentrations. In an individual, glucose tolerance is a function of insulin secretion, insulin action and SG. Under conditions of declining insulin secretion and action (e.g. type 2 diabetes), the degree of SG assumes increasing significance in determining the level of glucose tolerance both in fasted and postprandial states. Although the importance of SG has been recognized for years, mechanisms that contribute to SG are poorly understood. Research data on modulation of SG and its impact in glucose intolerance is limited. In this review, we will focus on the role of SG in the regulation of glucose tolerance, its evaluation, and potential advantages of therapies that can enhance glucose-induced stimulation of glucose uptake and suppression of its own production in conditions of impaired insulin secretion and action.
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Affiliation(s)
- Simmi Dube
- Gandhi Medical College, Bhopal, MP, India
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Weiss R, Magge SN, Santoro N, Giannini C, Boston R, Holder T, Shaw M, Duran E, Hershkop KJ, Caprio S. Glucose effectiveness in obese children: relation to degree of obesity and dysglycemia. Diabetes Care 2015; 38:689-95. [PMID: 25633663 PMCID: PMC4370330 DOI: 10.2337/dc14-2183] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Impaired glucose effectiveness (GE) plays a role in the deterioration of glucose metabolism. Our aim was to validate a surrogate of GE derived from an oral glucose tolerance test (OGTT) and to assess the impact of degrees of obesity and of glucose tolerance on it. RESEARCH DESIGN AND METHODS The OGTT-derived surrogate of GE (oGE) was validated in obese adolescents who underwent an OGTT and an intravenous glucose tolerance test (IVGTT). We then evaluated anthropometric determinants of the oGE and its impact on the dynamics of glucose tolerance in a cohort of children with varying degrees of obesity. RESULTS The correlation of oGE and IVGTT-derived GE in 98 obese adolescents was r = 0.35 (P < 0.001) as a whole and r = 0.51 (P < 0.001) in subjects with normal glucose tolerance. In a cohort of 1,418 children, the adjusted GE was associated with increasing obesity (P < 0.001 for each category of obesity). Quartiles of oGE and the oral disposition index were associated with 2-h glucose levels (P < 0.001 for both). Among 421 nondiabetic obese subjects (276 subjects with normal glucose tolerance/145 subjects with impaired glucose tolerance who repeated their OGTT after a mean time of 28 ± 16 months), oGE changes were tightly associated with weight (r = 0.83, P < 0.001) and waist circumference changes (r = 0.67, P < 0.001). Baseline oGE and changes in oGE over time emerged as significant predictors of the change in 2-h glucose levels (standardized B = -0.76 and B = -0.98 respectively, P < 0.001 for both). CONCLUSIONS The oGE is associated with the degree of and changes in weight and waist circumference and is an independent predictor of glucose tolerance dynamics.
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Affiliation(s)
- Ram Weiss
- Department of Human Metabolism and Nutrition, Hebrew University, Jerusalem, Israel
| | - Sheela N Magge
- Division of Endocrinology and Diabetes, Center for Translational Science, Children's National, Washington, DC
| | - Nicola Santoro
- Department of Pediatrics, Yale University, New Haven, CT
| | | | - Raymond Boston
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - Tara Holder
- Department of Pediatrics, Yale University, New Haven, CT
| | - Melissa Shaw
- Department of Pediatrics, Yale University, New Haven, CT
| | - Elvira Duran
- Department of Pediatrics, Yale University, New Haven, CT
| | - Karen J Hershkop
- Department of Human Metabolism and Nutrition, Hebrew University, Jerusalem, Israel
| | - Sonia Caprio
- Department of Pediatrics, Yale University, New Haven, CT
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Chang JS, You YH, Park SY, Kim JW, Kim HS, Yoon KH, Cho JH. Pattern of Stress-Induced Hyperglycemia according to Type of Diabetes: A Predator Stress Model. Diabetes Metab J 2013; 37:475-83. [PMID: 24404519 PMCID: PMC3881332 DOI: 10.4093/dmj.2013.37.6.475] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 06/27/2013] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND We aimed to quantify stress-induced hyperglycemia and differentiate the glucose response between normal animals and those with diabetes. We also examined the pattern in glucose fluctuation induced by stress according to type of diabetes. METHODS To load psychological stress on animal models, we used a predator stress model by exposing rats to a cat for 60 minutes and measured glucose level from the beginning to the end of the test to monitor glucose fluctuation. We induced type 1 diabetes model (T1D) for ten Sprague-Dawley rats using streptozotocin and used five Otsuka Long-Evans Tokushima Fatty rats as obese type 2 diabetes model (OT2D) and 10 Goto-Kakizaki rats as nonobese type 2 diabetes model (NOT2D). We performed the stress loading test in both the normal and diabetic states and compared patterns of glucose fluctuation among the three models. We classified the pattern of glucose fluctuation into A, B, and C types according to speed of change in glucose level. RESULTS Increase in glucose, total amount of hyperglycemic exposure, time of stress-induced hyperglycemia, and speed of glucose increase were significantly increased in all models compared to the normal state. While the early increase in glucose after exposure to stress was higher in T1D and NOT2D, it was slower in OT2D. The rate of speed of the decrease in glucose level was highest in NOT2D and lowest in OT2D. CONCLUSION The diabetic state was more vulnerable to stress compared to the normal state in all models, and the pattern of glucose fluctuation differed among the three types of diabetes. The study provides basic evidence for stress-induced hyperglycemia patterns and characteristics used for the management of diabetes patients.
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Affiliation(s)
- Jin-Sun Chang
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Young-Hye You
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Shin-Young Park
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Ji-Won Kim
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hun-Sung Kim
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Kun-Ho Yoon
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jae-Hyoung Cho
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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Nagasaka S, Kusaka I, Yamashita K, Funase Y, Yamauchi K, Katakura M, Ishibashi S, Aizawa T. Index of glucose effectiveness derived from oral glucose tolerance test. Acta Diabetol 2012; 49 Suppl 1:S195-204. [PMID: 22836490 DOI: 10.1007/s00592-012-0417-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 07/13/2012] [Indexed: 10/28/2022]
Abstract
Aim of this study was to formulate an index for glucose effectiveness (Sg), SgIo, based on 3-point (0, 30 and 120 min) 75 g oral glucose tolerance test (OGTT). The equation for SgI(O) was developed in the Chikuma cohort (n = 502). Firstly, post-loading plasma glucose without insulin action and Sg (PPG-without insulin and Sg) was calculated as follows: fasting plasma glucose (mg/dl) + [0.75 × 75,000]/[0.19 × BW(kg) × 10]. Secondly, 'PPG-without insulin/with Sg' was obtained from inverse correlation between log(10)DI(O) and 2-h post-glucose plasma glucose at OGTT (2hPG) in each glucose tolerance category: DI(O) denotes oral disposition index, a product of the Matsuda Index and δIRI(0-30)/δPG(0-30). Thirdly, expected 2hPG (2hPG(E)) of a given subject was obtained from the regression, and the ratio of 2hPG to 2hPG(E) (2hPG/2hPG(E)) was determined as an adjustment factor. Lastly, SgI(O) ([mg/dl]/min) was calculated as [PPG-without insulin and Sg]-[PPG-without insulin / with Sg] x [(2hPG) / 2hPG(E)]. SgI(O) was validated against Sg obtained by frequently sampled intravenous glucose tolerance test in the Jichi cohort (n = 205). Also, the accuracy of prediction of Sg by SgIo was tested by the Bland-Altman plot. SgI(O) was 3.61 ± 0.73, 3.17 ± 0.74 and 2.15 ± 0.60 in subjects with normal glucose tolerance (NGT), non-diabetic hyperglycemia and diabetes, respectively, in the Chikuma cohort. In the Jichi cohort, SgI(O) was significantly correlated with Sg in the entire group (r = 0.322, P < 0.001) and in subjects with NGT (r = 0.286, P < 0.001), and SgIo accurately predicted Sg. In conclusion, SgI(O) could be a simple, quantitative index for Sg.
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Affiliation(s)
- Shoichiro Nagasaka
- Division of Endocrinology and Metabolism, Diabetes Center, Department of Medicine, Jichi Medical University, Shimotsuke 329-0498, Japan
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12
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Seino S, Shibasaki T, Minami K. Dynamics of insulin secretion and the clinical implications for obesity and diabetes. J Clin Invest 2011; 121:2118-25. [PMID: 21633180 DOI: 10.1172/jci45680] [Citation(s) in RCA: 255] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Insulin secretion is a highly dynamic process regulated by various factors including nutrients, hormones, and neuronal inputs. The dynamics of insulin secretion can be studied at different levels: the single β cell, pancreatic islet, whole pancreas, and the intact organism. Studies have begun to analyze cellular and molecular mechanisms underlying dynamics of insulin secretion. This review focuses on our current understanding of the dynamics of insulin secretion in vitro and in vivo and discusses their clinical relevance.
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Affiliation(s)
- Susumu Seino
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
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13
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Dela F, Stallknecht B. Effect of physical training on insulin secretion and action in skeletal muscle and adipose tissue of first-degree relatives of type 2 diabetic patients. Am J Physiol Endocrinol Metab 2010; 299:E80-91. [PMID: 20407006 DOI: 10.1152/ajpendo.00765.2009] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Physical training affects insulin secretion and action, but there is a paucity of data on the direct effects in skeletal muscle and adipose tissue and on the effect of training in first-degree relatives (FDR) of patients with type 2 diabetes. We studied insulin action at the whole body level and peripherally in skeletal muscle and adipose tissue as well as insulin-secretory capacity in seven FDR and eight control (CON) subjects before and after 12 wk of endurance training. Training improved physical fitness. Insulin-mediated glucose uptake (GU) increased (whole body and leg; P < 0.05) after training in CON but not in FDR, whereas glucose-mediated GU increased (P < 0.05) in both groups. Adipose tissue GU was not affected by training, but it was higher (abdominal, P < 0.05; femoral, P = 0.09) in FDR compared with CON. Training increased skeletal muscle lipolysis (P < 0.05), and it was markedly higher (P < 0.05) in subcutaneous abdominal than in femoral adipose tissue and quadriceps muscle with no difference between FDR and CON. Glucose-stimulated insulin secretion was lower in FDR compared with CON, but no effect of training was seen. Glucagon-like peptide-1 stimulated insulin secretion five- to sevenfold. We conclude that insulin-secretory capacity is lower in FDR than in CON and that there is dissociation between training-induced changes in insulin secretion and insulin-mediated GU. Maximal GU rates are similar between groups and increases with physical training.
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Affiliation(s)
- Flemming Dela
- Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3, Copenhagen, Denmark.
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14
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Sam S, Sung YA, Legro RS, Dunaif A. Evidence for pancreatic beta-cell dysfunction in brothers of women with polycystic ovary syndrome. Metabolism 2008; 57:84-9. [PMID: 18078863 PMCID: PMC2710887 DOI: 10.1016/j.metabol.2007.08.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2007] [Accepted: 08/23/2007] [Indexed: 10/22/2022]
Abstract
Hyperandrogenemia and insulin resistance are heritable traits in sisters of women with polycystic ovary syndrome (PCOS). Hyperandrogenemia also appears to be the male reproductive phenotype; however, it is less clear whether male relatives are at risk for the metabolic disorders associated with PCOS. In this study, we tested the hypothesis that brothers of women with PCOS have defects in insulin action and/or secretion. Twenty-three non-Hispanic white brothers of women with PCOS and 23 non-Hispanic white control men of comparable age matched for body mass index underwent a modified frequently sampled intravenous glucose tolerance test. Parameters of insulin sensitivity and secretion were determined using minimal-model Bergman protocol. Disposition index was significantly decreased (2540 [1080, 3172] vs 2901 [2096, 4487], P = .009) independent of a family history of diabetes mellitus, and glucose effectiveness was significantly increased (2.4 [1.9, 2.7] vs 2.0 [1.8, 2.2], P = .02) in brothers compared with control men. We conclude that brothers of women with PCOS have evidence for pancreatic beta-cell dysfunction and may be at increased risk for type 2 diabetes mellitus.
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Affiliation(s)
- Susan Sam
- Division of Endocrinology, Metabolism and Molecular Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Yeon-Ah Sung
- Division of Endocrinology, Department of Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Richard S Legro
- Department of Obstetrics and, Gynecology, Pennsylvania State University College of Medicine, Hershey, PA
| | - Andrea Dunaif
- Division of Endocrinology, Metabolism and Molecular Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Affiliation(s)
- Kyu Jeung Ahn
- Department of Internal Medicine, Eulji University College of Medicine & Hospital, Korea.
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García Morillo JS, García-Junco PS, Miranda Guisado ML, Vallejo Maroto I, Pamies Andreu E, Muñiz Grigalvo O, Carneado de la Fuente J, Villar Ortiz J. [Glucose effectiveness and components of the metabolic syndrome in recently diagnosed hypertensive patients]. Med Clin (Barc) 2002; 119:527-30. [PMID: 12421519 DOI: 10.1016/s0025-7753(02)73484-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Glucose effectiveness (SG) is a parameter that indicates the glucose ability to clearing itself from the plasma independently of insulin's action. Our purpose was to analyze the cluster characteristics associated with the metabolic syndrome in a group of non-obese, recent-onset hypertensives and to test if there was a correlation with SG and the effectiveness of glucose at basal insulin point (GEZI). PATIENTS AND METHOD We studied 36 patients with mild hypertension with normal basal glucose levels. We determined plasma lipid subfractions, apolipoproteins and urate levels. An intravenous glucose tolerance test (TTGI) and minimal model analysis according to Bergman was performed and SG, GEZI and insulin sensitivity (SI) were calculated. RESULTS Patients with lower SG and GEZI had higher levels of total triglycerides (Tg) (r = 0.42; p = 0.01 and r = 0.48; p = 0.002, respectively) and triglycerides bind to VLDL (Tg-VLDL) (r = 0.40; p < 0.01 and r = 0.49; p = 0.002, respectively). When the cluster of metabolic syndrome was analyzed, SG was inversely related to uric acid levels and to the waist-hip index. However, SI was only related to the uric acid levels (r = 0.38; p = 0.01). CONCLUSIONS In non-obese, recently diagnosed hypertensive patients, the SG parameter seems to be an early marker for the development of metabolic syndrome.
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Affiliation(s)
- José Salvador García Morillo
- Unidad de Hipertensión Arterial y Lípidos. Servicio de Medicina Interna. Hospitales Universitarios Virgen del Rocío. Sevilla. España.
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Nishida Y, Tokuyama K, Nagasaka S, Higaki Y, Fujimi K, Kiyonaga A, Shindo M, Kusaka I, Nakamura T, Ishikawa SE, Saito T, Nakamura O, Sato Y, Tanaka H. S(G), S(I), and EGP of exercise-trained middle-aged men estimated by a two-compartment labeled minimal model. Am J Physiol Endocrinol Metab 2002; 283:E809-16. [PMID: 12217899 DOI: 10.1152/ajpendo.00237.2001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To examine the effects of physical training on glucose effectiveness (S(G)), insulin sensitivity (S(I)), and endogenous glucose production (EGP) in middle-aged men, stable-labeled frequently sampled intravenous glucose tolerance tests (FSIGTT) were performed on 11 exercise-trained middle-aged men and 12 age-matched sedentary men. The time course of EGP during the FSIGTT was estimated by nonparametric stochastic deconvolution. Glucose uptake-specific indexes of glucose effectiveness (S(2*)(G) x 10(2): 0.81 +/- 0.08 vs. 0.60 +/- 0.05 dl. min(-1). kg(-1), P < 0.05) and insulin sensitivity [S(2*)(I) x 10(4): 24.59 +/- 2.98 vs. 11.89 +/- 2.36 dl. min(-1). (microU/ml)(-1). kg(-1), P < 0.01], which were analyzed using the two-compartment minimal model, were significantly greater in the trained group than in the sedentary group. Plasma clearance rate (PCR) of glucose was consistently greater in the trained men than in sedentary men throughout FSIGTT. Compared with sedentary controls, EGP of trained middle-aged men was higher before glucose load. The EGP of the two groups was similarly suppressed by approximately 70% within 10 min, followed by an additional suppression after insulin infusion. EGP returned to basal level at approximately 60 min in the trained men and at 100 min in the controls, followed by its overshoot, which was significantly greater in the trained men than in the controls. In addition, basal EGP was positively correlated with S(2*)(G) . The higher basal EGP and greater EGP overshoot in trained middle-aged men appear to compensate for the increased insulin-independent (S(2*)(G)) and -dependent (S(2*)(I)) glucose uptake to maintain glucose homeostasis.
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Affiliation(s)
- Yuichiro Nishida
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya 464-8601, 814-0180 Japan
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18
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Grandinetti A, Keawe'aimoku Kaholokula J, Chang HK, Chen R, Rodriguez BL, Melish JS, Curb JD. Relationship between plasma glucose concentrations and Native Hawaiian Ancestry: The Native Hawaiian Health Research Project. Int J Obes (Lond) 2002; 26:778-82. [PMID: 12037647 DOI: 10.1038/sj.ijo.0802000] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2001] [Revised: 12/20/2001] [Accepted: 01/04/2001] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate the relationship between fasting glucose and 2 h glucose with percentage of Hawaiian ancestry and ethnic admixture. DESIGN Cross-sectional epidemiological study of type 2 diabetes and heart disease risk factor prevalence among Native Hawaiians. SUBJECTS A total of 578 Native Hawaiians residing in two rural communities were examined between 1993 and 1996. Sample sizes in statistical analyses varied due to missing data and selection criteria based on ethnic ancestry. MEASUREMENTS Percentage of Hawaiian ancestry and non-Hawaiian ethnic admixture, assessed by self-report. Fasting and 2 h post glucose challenge plasma glucose levels. Anthropometric measures (height, weight, waist and hip circumferences). Self-report of diet and physical activity. Medical history. RESULTS Increased Hawaiian blood quantum was significantly associated with increased fasting glucose (P=0.0047), increased body mass index (BMI; P<0.0001), waist-to-hip ratio (WHR; P=0.0103), and age (P<0.0001), but not with leisure time physical activity and total dietary caloric intake. This association was attenuated after adjusting for BMI and WHR, but not by age-adjustment alone. However, when the effects of descent from other ethnic groups was examined in a subset of participants, full-Hawaiians had significantly higher fasting glucose concentrations (7.28 mmol/l) than part-Hawaiians after adjustments for age, gender, BMI and WHR. In contrast, part-Hawaiians of predominantly Asian ancestry had the highest 2 h glucose concentrations (7.62 mmol/l). CONCLUSION These results suggest that ethnic admixture may be an important, but extremely complex, factor concerning the high prevalence of type 2 diabetes observed among this population. The complexity of this relationship may have obscured the relationship between ancestry and glucose tolerance in earlier observations of this population.
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Affiliation(s)
- A Grandinetti
- Pacific Biomedical Research Center, University of Hawaii at Manoa, Honolulu, Hawaii, USA.
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19
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Nishida Y, Higaki Y, Tokuyama K, Fujimi K, Kiyonaga A, Shindo M, Sato Y, Tanaka H. Effect of mild exercise training on glucose effectiveness in healthy men. Diabetes Care 2001; 24:1008-13. [PMID: 11375361 DOI: 10.2337/diacare.24.6.1008] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To detect whether mild exercise training improves glucose effectiveness (S(G)), which is the ability of hyperglycemia to promote glucose disposal at basal insulin, in healthy men. RESEARCH DESIGN AND METHODS Eight healthy men (18-25 years of age) underwent ergometer training at lactate threshold (LT) intensity for 60 min/day for 5 days/week for 6 weeks. An insulin-modified intravenous glucose tolerance test was performed before as well as at 16 h and 1 week after the last training session. S(G) and insulin sensitivity (S(I)) were estimated using a minimal-model approach. RESULTS After the exercise training, VO(2max) and VO(2) at LT increased by 5 and 34%, respectively (P < 0.05). The mild exercise training improves S(G) measured 16 h after the last training session, from 0.018 +/- 0.002 to 0.024 +/- 0.001 min(-1) (P < 0.05). The elevated S(G) after exercise training tends to be maintained regardless of detraining for 1 week (0.023 +/- 0.002 min(-1), P = 0.09). S(I) measured at 16 h after the last training session significantly increased (pre-exercise training, 13.9 +/- 2.2; 16 h, 18.3 +/- 2.4, x10(-5). min(-1). pmol/l(-1), P < 0.05) and still remained elevated 1 week after stopping the training regimen (18.6 +/- 2.2, x10(-5). min(-1). pmol/l(-1), P < 0.05). CONCLUSIONS Mild exercise training at LT improves S(G) in healthy men with no change in the body composition. Improving not only S(I) but also S(G) through mild exercise training is thus considered to be an effective method for preventing glucose intolerance.
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Affiliation(s)
- Y Nishida
- Research Center of Health, Physical Fitness, and Sports, Nagoya University, Nagoya, Japan
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21
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Kobayashi K, Amemiya S, Higashida K, Ishihara T, Sawanobori E, Kobayashi K, Mochizuki M, Kikuchi N, Tokuyama K, Nakazawa S. Pathogenic factors of glucose intolerance in obese Japanese adolescents with type 2 diabetes. Metabolism 2000; 49:186-91. [PMID: 10690942 DOI: 10.1016/s0026-0495(00)91221-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
We attempted to identify the pathogenic factors involved in the progression to type 2 diabetes in obese Japanese adolescents. Subjects included 18 nondiabetic obese adolescents, 12 obese adolescents with type 2 diabetes on diet therapy, 10 obese adolescents with type 2 diabetes manifesting ketosis at onset or with a history of treatment with hypoglycemic agents, and 26 non-obese adolescent control subjects. The first-phase insulin response (FPIR), glucose disappearance constant (Kg), glucose effectiveness (Sg), and insulin sensitivity (S(I)) were obtained using an insulin-modified frequently sampled intravenous glucose tolerance test (FSIGT) and a minimal model analysis. The disposition index (DI, by FPIR x S(I)) was determined to assess any endogenous insulin effect. The results showed that Kg was decreased significantly (P = .0006) with the progression to severe diabetes in the obese groups. Although S(I) and Sg did not differ significantly among the 3 obese groups, both parameters were significantly lower in each obese group versus the non-obese controls. As a result of the significant decrease in FPIR (P < .0001), the DI decreased (P = .0006) with the progression to severe diabetes in the obese groups. In conclusion, an early manifestation of type 2 diabetes with occasional ketosis at onset may result from beta-cell dysfunction to glucose stimulation. This finding is demonstrated by the relatively low FPIR to decreased S(I) in obese Japanese adolescents, as well as the low Sg as a synergic role in glucose intolerance. The present findings from a Japanese population for pathogenic factors aside from obesity may help us to gain a better understanding of the progression to adolescent, early-onset, obese type 2 diabetes and its severity.
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Affiliation(s)
- K Kobayashi
- Department of Pediatrics, Yamanashi Medical University, Nakakoma-gun, Japan
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Araújo-Vilar D, García-Estévez DA, Cabezas-Cerrato J. Insulin sensitivity, glucose effectiveness, and insulin secretion in nondiabetic offspring of patients with non-insulin-dependent diabetes mellitus: a cross-sectional study. Metabolism 1999; 48:978-83. [PMID: 10459561 DOI: 10.1016/s0026-0495(99)90193-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
To evaluate the factors that determine the worsening of intravenous glucose tolerance in subjects at high risk for developing non-insulin-dependent diabetes mellitus (NIDDM), 15 glucose-tolerant offspring of NIDDM patients and 21 control subjects were studied. Each subject underwent a frequently sampled intravenous glucose tolerance (FSIGT) test. The intravenous glucose tolerance index (K(G) index) was calculated between minutes 10 and 40 of a FSIGT test. Insulin sensitivity (S(I)), glucose effectiveness at zero insulin (GEZI), and first- and second-phase insulin responsiveness (phi1 and phi2) were estimated using glucose and insulin kinetic minimal models. The acute insulin response to glucose (AIRg) was calculated as the area under the insulin curve above the basal level between 0 and 10 minutes, and the suprabasal insulin effect was determined by the product of S(I) times AIRg. Offspring had a lower S(I) than control subjects (14.1 +/- 7.5 v 9.25 +/- 4.20 x 10(-5) x min(-1)(pmol x L(-1))(-1), P < .01), and their AIRg was similar (3,284 +/- 2,280 v 3,105 +/- 1,499 pmol x L(-1), NS). Sample division according to the median K(G) value showed that control subjects with low tolerance had a lower AIRg (4,417 +/- 2,531 v 2,043 +/- 1,068 pmol x L(-1), P < .05) and a lower suprabasal insulin effect (0.057 +/- 0.03 v 0.023 +/- 0.009 min(-1), P < .05) than control subjects with high tolerance. Offspring with low tolerance had a lower AIRg (2,574 +/- 1,197 v 3,707 +/- 1,656 pmol x L(-1), P < .05) and a lower GEZI (0.101 +/- 0.05 v 0.212 +/- 0.08 x 10(-1) x min(-1), P < .05) than offspring with high tolerance. Offspring with high and low tolerance showed lower phi1 (375 +/- 155 v 272 +/- 181 v 698 +/- 336 (pmol x L(-1))min(mmol x L(-1)), NS) than control subjects with high tolerance. In conclusion, our data suggest that decreases in GEZI and AIRg are the main factors responsible for the worsening of intravenous glucose tolerance in the offspring of NIDDM patients.
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Affiliation(s)
- D Araújo-Vilar
- Department of Medicine, Complejo Hospitalario Universitario de Santiago de Compostela, School of Medicine, University of Santiago de Compostela, Spain
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