Glucose Concentration Curve Research Articles

Metabolic Effects of Glucagon Stimulations in Type 1 Diabetes and Healthy Controls.

Metabolic responses to glucagon beyond the promotion of endogenous glucose production in type 1 diabetes remains poorly explored. Therefore, we aimed to investigate the metabolic responses to glucagon stimulation in type 1 diabetes and explore whether recent exposure to hypoglycemia would impact glucagon sensitivity. Twenty-nine participants, 19 with type 1 diabetes and ten healthy controls, underwent a hyperinsulinemic-euglycemic clamp with five-stepwise ascending glucagon injections. Metabolic responses were assessed before and during each glucagon injection. During the glucagon injections, the series of the incremental area under the curve of plasma glucose concentration did not differ between the groups. However, during the first injection of 10 μg glucagon, participants with type 1 diabetes produced a higher incremental area under the plasma glucose concentration curve than healthy controls. Plasma concentration of non-esterified fatty acids, glycerol, and metabolites from metabolomic analyses did not differ between the groups. In participants with type 1 diabetes, exposure to hypoglycemia did not impact the metabolic responses induced by glucagon. Generally, metabolic responses to glucagon stimulation in type 1 diabetes are similar to healthy controls. However, elevated glucose production was observed following the lowest glucagon dose in participants with type 1 diabetes compared to healthy controls, indicating enhanced glucagon sensitivity to low-dose glucagon stimulations. NCT05095259.

Influence of gut bile acid composition on the glucose‐lowering effect and safety of metformin

AimsThis study evaluates how changes in intestinal bile acid composition, induced by cholestyramine, a bile acid sequestrant, affect metformin's pharmacodynamics (PD).MethodsAn open‐label, 2‐period 1‐sequence crossover study was conducted with healthy male adults. Each period consisted of both before and after metformin treatments. Cholestyramine was administered during the second period to change the bile acid pool. For, PD assessment, an oral glucose tolerance test was conducted at each treatment in both periods. Metformin was administered 3 times during each period, and cholestyramine was administered 3 times per day for 7 days during the second period. Maximum serum glucose concentration, area under the glucose concentration curve and homeostatic model assessment of insulin resistance were calculated. Baseline‐corrected PD parameters were derived by subtracting pre‐metformin values from post‐metformin values. Lipid and panels and bile acid profiles in stool were measured. Adverse events were monitored throughout the study.ResultsFourteen subjects completed the study. The mean values of 3 PD parameters were all decreased after metformin administration in both periods. Cholestyramine administration led to a further decrease in baseline‐corrected PD parameters, significantly reducing the area under the glucose concentration curve by 44.7%. Diarrhoea, the most common adverse event, was reported in 10 subjects during the metformin alone treatment and in 1 subject during the cholestyramine combined treatment (P < .01).ConclusionCholestyramine affected the glucose‐lowering effect of metformin by the possible change in the bile acid pool in the gut, and metformin‐associated diarrhoea was improved by cholestyramine.

A Single Sauna Session Does Not Improve Postprandial Blood Glucose Handling in Individuals with Type 2 Diabetes Mellitus: A Cross-Over, Randomized, Controlled Trial.

Passive heat treatment has been suggested to improve glycemic control in individuals with type 2 diabetes mellitus (T2DM). Previous studies have focused predominantly on hot water immersion and traditional sauna bathing, as opposed to the more novel method of infrared-based sauna bathing. Here, the impact of a single infrared sauna session on post-prandial glycemic control was assessed in older individuals with T2DM. In this randomized controlled crossover trial, 12 participants with T2DM (male/female: 10/2, age: 69±7 y, BMI: 27.5±2.9 kg/m2) rested in an infrared sauna twice: once in a heated (60°C) and once in a thermoneutral (21°C) condition for 40 min, immediately followed by a 2-h oral glucose tolerance test (OGTT). Venous blood samples were obtained to assess plasma glucose and insulin concentrations and to determine the whole-body composite insulin sensitivity index. Body core and leg skin temperature were higher following the heated condition compared to the thermoneutral condition (38.0±0.3 vs. 36.6±0.2°C and 39.4±0.8 vs. 31.3±0.8°C, respectively; P<0.001 for both). The incremental area under the curve (iAUC) of plasma glucose concentrations during the OGTT was higher after the heated condition compared to the thermoneutral condition (17.7±3.1 vs. 14.8±2.8 mmol/L/120 min; P<0.001). No differences were observed in plasma insulin concentrations (heated: 380±194 vs. thermoneutral: 376±210 pmol/L/120 min; P=0.93) or whole-body composite insulin sensitivity indexes (4.5±2.8 vs. 4.5±2.1; P=0.67). A single infrared sauna session does not improve postprandial blood glucose handling in individuals with T2DM. Future studies should assess the effect of more prolonged application of infrared sauna bathing on daily glycemic control.

The different associations of serum gamma-glutamyl transferase and alanine aminotransferase with insulin secretion, β-cell function, and insulin resistance in non-obese Japanese

The present study investigated the associations of serum gamma-glutamyl transferase (GGT), a marker of fatty liver and oxidative stress, and ALT/AST, a marker of fatty liver, with percentage trunk fat and postload glucose, insulin resistance, and β-cell function in middle-aged Japanese individuals, whose BMI averaged < 23.0 kg/m2. Pancreatic β-cell function was assessed using the disposition index calculated by a product of the insulinogenic index (IGI) and Matsuda insulin sensitivity index, a biomarker of early-phase glucose-stimulated insulin secretion and whole-body insulin sensitivity, respectively. Multivariate linear regression analyses revealed that the disposition index was associated inversely with GGT independently of percentage trunk fat, homeostasis model assessment insulin resistance (HOMA-IR), a marker of insulin resistance, and Matsuda index. When IGI was included instead of the disposition index, IGI (inversely) and HOMA-IR were associated with GGT independently of percentage trunk fat and Matsuda index. When the area under the glucose concentration curve (AUCg) during an oral glucose tolerance test was included instead of the disposition index, AUCg and HOMA-IR emerged as independent determinants of GGT. ALT/AST was associated with HOMA-IR alone. Results suggest a different pathophysiologic basis between GGT and ALT/AST in predicting diabetic risk in non-obese Japanese.

Low muscle mass is associated with low insulin sensitivity, impaired pancreatic β cell function, and high glucose excursion in nondiabetic nonobese Japanese women

AimWe tested whether skeletal muscle mass is associated with insulin sensitivity, pancreatic β-cell function, and postglucose glycemia. MethodsAppendicular skeletal muscle mass (ASM) (relative to body size, %ASM) by DXA, surrogate measures of insulin sensitivity, insulin secretion and the disposition index (insulin sensitivity adjusted insulin secretion: a product of the insulinogenic index and Matsuda insulin sensitivity index) inferred from serum insulin kinetics during a 75 g oral glucose tolerance test (OGTT) were evaluated in 168 young and 65 middle-aged women, whose BMI averaged <23.0 kg/m2 and HbA1c ≦ 5.5 %. ResultsIn two groups of women, %ASM was associated negatively with homeostasis model assessment insulin resistance (HOMA-IR) and 2-h insulin (both p < 0.01 or less). In middle-aged women not in young women, %ASM was associated inversely with the Matsuda index (p < 0.001). In middle-aged women only, it also showed a positive association with the disposition index (p = 0.02) and inverse associations with 1-h and 2-h glucose (both p < 0.01) and area under the glucose concentration curve during OGTT (p = 0.006). On multivariate linear regression analyses, 2-h insulin emerged as a determinant of %ASM independently of HOMA-IR in young women (standardized β: 0.287, p < 0.001, R2 = 0.077). In middle-aged women, the Matsuda index emerged as a determinant of %ASM (standardized β: 0.476, p < 0.001) independently of HOMA-IR, log ODI and AUCg and explained 21.3 % of %ASM variability. Post-glucose glycemia and AUCg were higher and log ODI was lower in middle-aged women with low compared with high %ASM. ConclusionLow skeletal muscle mass (relative to body size) was associated with low insulin sensitivity in young and middle-aged Japanese women who were neither obese nor diabetic. Middle-aged women with low muscle mass had low disposition index, an early marker of inadequate pancreatic β-cell compensation, and hence high glucose excursion. Low skeletal muscle mass may be associated with the development of type 2 diabetes at a much lower BMI in Japanese people.

Study on the effectiveness of postprandial blood glucose control and glycemic index of acetylated wheat flour in healthy volunteers

Background: The study was conducted to determine the ability to control postprandial blood glucose response and glycemic index of acetylated wheat starch cakes containing 31,2% of resistant starch on 12 healthy volunteers. Material and methods: Research designed using experimental and double-blind methods. During the two days of the clinical trial, after more than 12 hours of overnight fasting, each volunteer consumed a diet consisting of 1 cake containing 50 g of acetylated wheat starch or 50 g of natural wheat starch and 330 ml of filtered water in 15 minutes. Volunteers had determined their capillary blood glucose concentrations at times before meals, 60 and 120 minutes after meals. Results: Blood glucose concentration at 60 minutes after eating acetylated wheat starch cake (G1= 8.6 ± 0.8 mmol/L) was lower than natural wheat starch cake (G1= 11.7 + 1.1 mmol/L) (p &lt; 0.05). Similarly, blood glucose concentration at 120 minutes after eating acetylated wheat starch cake (G2= 7.1 ± 0.7 mmol/L) was lower than natural wheat starch cake (G2= 9.2 ± 1.7 mmol/L) (p &lt; 0.05). The area under the curve of blood glucose concentration after 120 minutes of eating natural wheat starch cake (AUC0-120min= 337.0 min*mmol/L) is doulble times larger than the acetylated wheat starch cake (AUC0-120min= 175.5 min*mmol/L) (p &lt; 0.05). Glycemic index of acetylated wheat starch cake is 52.0. Conclusion: Acetylated wheat starch cake has a low glycemic index, possessing the ability to control postprandial blood glucose effectively, limiting the increase of postprandial blood glucose concentration within the safe range, and it did not cause any digestive disorders in volunteers. This is very meaningful in the application of acetylated wheat starch to process foods not only for diabetic patients but also for pre-diabetic or overweight and obese people to support treatment and improve quality of life. Key words: resistant starch, blood glucose, glycemic index, volunteers.

Effects of a Novel Glucokinase Activator, Dorzagliatin, on Glycemic Control and Glucose Fluctuation in Drug-Naïve Patients with Type 2 Diabetes Mellitus.

The prevalence rate of type 2 diabetes mellitus (T2DM) has been increasing and a large proportion of patients still do not achieve adequate or sustainable glycemic control on the basis of previous hypoglycemic treatment. In this present study, we explored whether dorzagliatin, a novel glucokinase activator (GKA), could improve glycemic control and lessen glucose fluctuation in drug-naïve patients with T2DM. A self-comparative observational study of 25 drug-naïve patients with T2DM (aged 18-75 years and HbA1c of 7.5%-11.0%) treated with dorzagliatin 75 mg twice daily for 52 weeks. Before and after dorzagliatin intervention, the serum levels of hemoglobin A1c (HbA1c), insulin, and C-peptide were measured repeatedly during fasting and after a mixed meal. The continuous glucose monitoring (CGM) device was also used to obtain 24-hour glucose profiles and assess the changes in glycemic variability parameters. After 52 weeks of treatment with dorzagliatin, a numerally greater reduction in HbA1c of 1.03% from the baseline was observed in patients with T2DM, accompanied by significant improvement in insulin resistance and insulin secretion. Moreover, the standard deviation of blood glucose (SDBG) and the mean amplitude of glycemic excursion (MAGE) derived from CGM data were significantly decreased after dorzagliatin therapy. The 24-h glucose variation profile showed that study patients had obviously lower mean glucose levels during the postprandial period from the baseline to week 52, an effect also demonstrated by the significant decrease in the incremental area under glucose concentration versus time curve for 2 h (iAUC0-2 h) after meals. This study suggests that dorzagliatin therapy could effectively improve glycemic control and glucose fluctuation in drug-naïve patients with T2DM.

Dose-Dependency of the Glycemic Response to Polyphenol-Rich Sugarcane Extract (PRSE)

Foods high in available carbohydrates, such as plain white sugar or sucrose, increase the postprandial blood glucose levels that may aggravate the risk of developing Type 2 Diabetes. One class of compounds that is gaining popularity due to its potential application in reducing the release of sugars for absorption into the body is polyphenols. The study aimed to investigate the effect of adding different doses of polyphenol-rich sugarcane extract (PRSE) to sucrose to lower the postprandial glycemia of the participants in a non-randomized study. The four test samples’ Glycemic Index (GI) values were calculated based on the standardized recommended methodology by comparing the area under the curve (AUC) of the test samples against the glucose standard. The glucose concentration curves were similar for the four test foods. The glucose response curves, and GI values were decreased in a dose-dependent manner. The results of this study indicate that PRSE-coated sugar can lower postprandial glycemia in normal individuals. Additionally, decreasing GI values with an increasing concentration of polyphenols suggests a dose-dependent effect between polyphenol levels and GI.

Cortisol secretion and abnormalities of glucose metabolism in nondiabetic patients with hypertension.

Glycometabolic changes are associated with hypercortisolism in Cushing's syndrome. Because impaired glucose tolerance (IGT) and insulin resistance are frequently detected in patients with essential hypertension, we hypothesized that in these patients, early glycometabolic abnormalities might be related to differences in regulation of cortisol secretion. In a cross-sectional study, we included 155 nondiabetic, essential hypertensive patients who were free of organ complications. The homeostasis model assessment (HOMA) index and the area under the curve of plasma glucose (AUC-glucose) and insulin (AUC-insulin) concentration following an oral glucose tolerance test were measured, together with daily plasma cortisol (8 a.m., 3 p.m. and 12 a.m.; AUC-cortisol) and 8 a.m. cortisol after 1 mg overnight dexamethasone suppression test (DST). IGT was present in 27% of patients who were older and had higher BMI, plasma triglycerides and uric acid, AUC-cortisol and DST-cortisol, and lower HDL-cholesterol. Frequency of IGT increased progressively across tertiles of DST-cortisol, together with levels of glycated hemoglobin, fasting insulin and C-peptide, HOMA-index, AUC-glucose, and AUC-insulin. AUC-cortisol and DST-cortisol were directly correlated with insulin, C-peptide, HOMA-index, AUC-glucose, and AUC-insulin. Multivariate regression analysis showed that DST-cortisol was directly and independently correlated with HOMA index, AUC-glucose, and AUC-insulin. In a logistic regression model, both AUC-cortisol and DST-cortisol independently predicted IGT. Daily cortisol and cortisol response to DST are independent determinants of IGT and insulin resistance in nondiabetic patients with hypertension, suggesting that even subtle differences in regulation of cortisol secretion might increase the risk of these patients to develop diabetes.

980-P: Quantitatively Integrating Carbohydrate Counting, Insulin (I), and Continuous Glucose Monitoring (CGM)

Introduction: Diabetes Care Education Specialists teach patients with insulin requiring Type 1 and 2 diabetes to develop CHO/I ratios to manage mixed diet glucose (G) excursions and improve A1c. and qualitatively examine summary CGM data when available. Conversely, medical scientists have used complex mathematical models, with/without radiolabeled glucose to describe meal-related glucose excursions. Method: This study bypasses the above complexities as CGM regularly measures interstitial fluid glucose (ISFG) over time. CGM can define an individual’s meal specific G/I ratio as well as define Glucose Clearance (GCL) and Insulin Sensitivity Index (Si}. The approach uses referenced meal carbohydrate information (mg CHO). CGM frames the timing (T = t1 - t0) and amount (I) administered before the timed glucose excursion and return to baseline (t2 - t1). This and an Interstitial fluid (ISF) Volume of Distribution (Vd in dL) = 0.15*kg body weight*10 corrected for blood glucose values defines Timed Insulin Glucose Clearance ((T,I)GCL) = (T,I)Vd/(t2 - t1) and (T,I)Si = (T,I)GCL/I). (ISF) glucose for that meal.: Gisf = dietary glucose (Gd)/1.1. Rate Glucose disappearance from ISF space Gisf/(t2 - t1). Discussion: The above parameters are patient specific and refer to the insulin related glucose disposal for that meal. They assess the glucose excursion using the timing and amount of insulin as well the inferring effect of the other dietary components, e.g., protein and fat that contribute to T, and t2 - t1. It avoids complicated descriptions of the glucose curve as it begins with glucose input. It includes hepatic glucose uptake and glucose production, as well as insulin resistance as these are reflected in prolonging of t1-t0 and t2 - t1. Conclusion: CGM has provided the time values for the onset and duration of the meal-related glucose concentration curve. As with Vg, this will assist a patient to develop individualized (I) responses to complex meals using parameters unavailable before CGM. Disclosure J.S.Melish: None.

Relationships between feeding and glucose concentrations in healthy term infants during the first five days after birth-the Glucose in Well Babies Study (GLOW).

The World Health Organization recommends breastfeeding be commenced as soon as possible after birth. Amongst other benefits, early feeding is expected to support the metabolic transition after birth, but effects on blood glucose concentrations are controversial. We sought to describe the changes in interstitial glucose concentrations after feedings over the first five postnatal days. In healthy singleton term infants, all feeds were recorded using a smart phone app. Glucose concentrations were measured by blinded interstitial monitoring, calibrated by heel-prick capillary samples 2-4 times/d. Feeding sessions were included if a start and end time were recorded, and if the interval between the start of successive feeds was >90 min. The area under the glucose concentration curve (AUC) was calculated by trapezoidal addition from baseline (median of the 3 measurements before the beginning of the session). The maximum deviation (MD) was the greatest change in glucose concentration (positive or negative) from baseline to the next feeding session or 180 min, whichever came first. Data were analyzed using Stata V17 and are presented as mean (95% CI) in mmol/L. Data were available for 62 infants and 1,770 feedings. The glucose response to breastfeeding was not different from zero on day 1 [day 1 AUC 0.05 (-0.00, 0.10), MD 0.06 (-0.05, 0.16)], but increased thereafter (day 3 (AUC 0.23 (0.18, 0.28), MD 0.41 (0.32, 0.50), day 5 AUC 0.11 (0.06, 0.16), MD 0.28 (0.18, 0.37), p < 0.001 for age effect). Glucose response increased with increased duration of breastfeeding (<30 min AUC 0.06 (0.02,0.09), MD 0.12 (0.04,0.19), >30 min AUC 0.20 (0.16, 0.23) MD 0.37 (0.30, 0.44), p < 0.001 for duration effect) and this was observed even in the first 2 days (<30 min AUC-0.02 (-0.06, 0.03), MD -0.06 (-0.15, 0.03), >30 min AUC 0.12 (0.08, 0.16), MD 0.19 (0.11, 0.27), overall p < 0.001 for age x duration interaction). In feeding sessions that were not breastfeeding, the glucose response was greater after formula than after expressed human milk [AUC 0.29 (0.15, 0.29), MD 0.48 (-0.12, 0.61)], and greater after feed volumes >20 ml than <10 ml [20-30 ml AUC 0.19 (0.01, 0.27), MD 0.23 (-0.01, 0.46)]. The glucose response to feeding in the days after birth increases with postnatal age and duration of the feeding episode. Breastfeeding for <30 min has little effect on glucose concentrations in the first two days.

Peroxidase-Mimicking Hierarchically Organized Gold Particles for Glucose Detection.

In this work, we synthesize a series of hierarchically organized gold nanoparticles (Au HOPs-X) with peroxidase (POD)-like catalytic activity by the in situ reduction of Au-thiolate hierarchically organized particles (Au HOPs). The initial Au HOPs show little POD-like catalytic activity. However, after the reduction of the particles, the Au HOPs-X showed enhanced POD-like catalytic activity, where X represents the reduction degree of Au HOPs. The reasons are as follows: (1) the Au-thiolate complexes on the surface of the Au HOPs-X were reduced into Au nanoparticles, and the active Au0 content increases with the increase of the reduction degree; (2) the specific surface area of Au HOPs-X becomes larger. Based on this, the Au HOPs-10 with the highest catalytic activity were combined with glucose oxidase to obtain a standard curve as a function of glucose concentrations. The color of the solutions was captured by mobile phone photos to determine their saturation, and the rapid detection of glucose was achieved through the standard curve of glucose concentration and saturation determined in this study.

Wasabi (Eutrema japonicum) Reduces Obesity and Blood Pressure in Diet-Induced Metabolic Syndrome in Rats.

6-(Methylsulfinyl)hexyl isothiocyanate (6-MSITC) has several biological functions. The present study aimed to evaluate the composition of hydroponically grown Tasmanian wasabi (Eutrema japonicum (Miq.) Koidz.) for 6-MSITC in all plant tissues and investigate the influence of wasabi (rhizome and stem blend) in high-carbohydrate, high-fat (H) diet-fed rats. Male Wistar rats were fed either a corn starch (C) or H diet. After the initial 8 weeks, half of the animals on the C and H diets were given 5% (w/w) wasabi powder in their respective diets for an 8-week duration (CW and HW). The control animals received diets without supplementation throughout the 16-week experiment. Our findings demonstrated that wasabi grown under hydroponic conditions contained 6-MSITC in all parts of the plant such as the stem, leaf and flower, as well as the commonly used rhizome, albeit at lower concentrations. Rats treated with wasabi showed reductions in body weight (H, 460.0 ± 9.5; HW, 416.0 ± 3.6 g), fat mass (H, 178 ± 14; HW, 120 ± 23 g), plasma triglycerides (H, 1.7 ± 0.3; HW, 0.9 ± 0.3 mmol/L) and total cholesterol (H, 1.5 ± 0.1; HW, 1.0 ± 0.04 mmol/L), and the plasma activities of aspartate transaminase. Systolic blood pressure and the area under the curve of blood glucose concentration were decreased by wasabi treatment. Thus, wasabi may be a novel alternative treatment to assist in the management of obesity and related metabolic disorders.

Evaluation of the metabotype concept after intervention with oral glucose tolerance test and dietary fiber-enriched food: An enable study

Background and aimsEvidence suggests that people react differently to the same diet due to inter-individual differences. However, few studies have investigated variation in response to dietary interventions based on individuals' baseline metabolic characteristics. This study aims to examine the differential reaction of metabotype subgroups to an OGTT and a dietary fiber intervention. Methods and resultsWe assigned 356 healthy participants of an OGTT sub-study and a 12-week dietary fiber intervention sub-study within the enable cluster to three metabotype subgroups previously identified in the KORA F4 study population. To explore the association between plasma glucose level and metabotype subgroups, we used linear mixed models adjusted for age, sex, and physical activity. Individuals in different metabotype subgroups showed differential responses to OGTT. Compared to the healthy metabotype (metabotype 1), participants in intermediate metabotype (metabotype 2) and unfavorable metabotype (metabotype 3) had significantly higher plasma glucose concentrations at 120 min after glucose bolus (β = 7.881, p = 0.005; β = 32.79, p < 0.001, respectively). Additionally, the linear regression model showed that the Area under the curve (AUC) of plasma glucose concentrations was significantly different across the metabotype subgroups. The associations between metabotype subgroups and metabolic parameters among fiber intervention participants remained insignificant in the multivariate-adjusted linear model. However, the metabotype 3 had the highest mean reduction in insulin, cholesterol parameters (TC, LDLc, and non-HDLc), and systolic and diastolic blood pressure at the end of the intervention period. ConclusionThis study supports the use of the metabotype concept to identify metabolically similar subgroups and to develop targeted dietary interventions at the metabotype subgroup level for the primary prevention of diet-related diseases.

1425-P: Effect of Ghrelin on Glucose Tolerance after Sleeve Gastrectomy

Introduction: Ghrelin is an appetite-stimulating peptide hormone secreted from the gastric mucosa in the fasting state that decreases in response to food intake. After sleeve gastrectomy (SG) , plasma levels of ghrelin decrease dramatically, whether this may influence glucose tolerance is unknown. We therefore investigated the effects of physiological ghrelin infusions on glucose tolerance in individuals with obesity before and after SG. Methods: Nine morbidly obese individuals with normal glucose tolerance, scheduled for SG, were enrolled. Four-hour standard mixed-meal tests with concomitant patient-blinded infusions of either acyl-ghrelin (1 pmol/kg/min) or placebo (saline) were performed in randomized order before and 3 months after surgery. All values are mean ± SEM. Results: Before SG, fasting plasma glucose was unaffected by ghrelin infusion, whereas both peak (7.93 ± 0.3 mmol/L versus 6.98 ± 0.2, p&amp;lt;0.001) and total area under the curve (tAUC) of plasma glucose concentrations (1874 ± 61 mmol/L*min versus 1702 ± 42, p=0.03) increased significantly during ghrelin infusion versus placebo. After SG, fasting plasma glucose was again unaffected by ghrelin infusion, whereas peak of plasma glucose increased (8.65 ± 0.5 mmol/L versus 7.92 ± 0.3 mmol/L, p=0.04) and tAUC of plasma glucose tended to increase (1817 ± 73 mmol/L*min versus 1636 ± 44 mmol/l*min, p=0.054) during ghrelin infusions versus placebo. The increase in tAUC during ghrelin infusion versus placebo was 10% before surgery and 11% after SG (p=0.98) . Conclusion: Ghrelin infusions increased postprandial plasma glucose concentrations in obese individuals both before and following SG, suggesting a role of ghrelin in the regulation of postprandial glucose metabolism. This response appears to be maintained following SG and the low levels of ghrelin after SG may thus contribute to the improved glucose control after the operation. Disclosure N.Hedbäck: None. S.Madsbad: None. M.Dichman: None. C.Dirksen: None. K.N.Bojsen-moller: None. N.B.Jørgensen: Advisory Panel; Novo Nordisk A/S, Research Support; Boehringer Ingelheim International GmbH, Speaker's Bureau; Novo Nordisk A/S, Stock/Shareholder; Eli Lilly and Company, Novo Nordisk A/S. M.G.Hindsø: Research Support; Novo Nordisk Foundation. V.B.Kristiansen: None. J.J.Holst: Advisory Panel; Novo Nordisk, Board Member; Antag Therapeutics, Bainan Biotech. M.S.Svane: None. Funding European Research Council (Grant 695069-BYPASSWITHOUTSURGERY) Novo Nordisk Foundation

Riceberry rice beverage decreases postprandial glycemic response, inflammatory markers and antioxidant status induced by a high-carbohydrate and moderate-fat meal in overweight and obese men.

Recent clinical studies support the beneficial role of riceberry rice and its food products in controlling the glycemic response in healthy subjects. The aim of the current work was to determine the effects of riceberry rice beverage (RRB) on postprandial glycemic, insulin and triglyceride responses, inflammatory biomarkers, and antioxidant status as well as appetite sensation following a high-carbohydrate and moderate-fat (HCMF) meal in overweight/obese subjects. Thirteen participants, overweight and obese men (age = 24.46 ± 0.90 years and BMI = 25.92 ± 0.69 kg m-2), completed a randomized, crossover intervention study. They consumed an HCMF meal with or without RRB (2 g of riceberry rice extract powder/400 ml). Blood samples and appetite sensation were measured at the fasting state and up to 6 h after meal consumption. The ingestion of the HCMF meal accompanied by RRB had a lower incremental area under the curve (iAUC) for postprandial plasma glucose, insulin, malondialdehyde (MDA) and serum triglyceride concentrations when compared to the control. A significant increase in the ferric reducing ability of plasma (FRAP), Trolox equivalent antioxidant capacity (TEAC), and thiol level, all measures of antioxidant capacity, was also observed in the participants who consumed the HCMF meal accompanied by RRB. The postprandial level of pro-inflammatory cytokines (IL-1β, IL-6 and TNF-α) significantly increased at 3 h and 6 h after the HCMF meal intake when compared to the fasting state. Interestingly, these values were significantly decreased upon consumption of RRB. However, there were no statistically significant differences in the rating scores of hunger, fullness, desire to eat, and satiety among the tested meals. In conclusion, RRB intake prevented HCMF meal-induced postprandial glycemic, lipemic, and pro-inflammatory responses and improved plasma antioxidant capacity in overweight and obese participants.

A Dual Electrode Biosensor for Glucose and Lactate Measurement in Normal and Prolonged Obese Mice Using Single Drop of Whole Blood.

Understanding the levels of glucose (G) and lactate (L) in blood can help us regulate various chronic health conditions such as obesity. In this paper, we introduced an enzyme-based electrochemical biosensor adopting glucose oxidase and lactate oxidase on two working screen-printed carbon electrodes (SPCEs) to sequentially determine glucose and lactate concentrations in a single drop (~30 µL) of whole blood. We developed a diet-induced obesity (DIO) mouse model for 28 weeks and monitored the changes in blood glucose and lactate levels. A linear calibration curve for glucose and lactate concentrations in ranges from 0.5 to 35 mM and 0.5 to 25 mM was obtained with R-values of 0.99 and 0.97, respectively. A drastic increase in blood glucose and a small but significant increase in blood lactate were seen only in prolonged obese cases. The ratio of lactate concentration to glucose concentration (L/G) was calculated as the mouse’s gained weight. The results demonstrated that an L/G value of 0.59 could be used as a criterion to differentiate between normal and obesity conditions. With L/G and weight gain, we constructed a diagnostic plot that could categorize normal and obese health conditions into four different zones. The proposed dual electrode biosensor for glucose and lactate in mouse whole blood showed good stability, selectivity, sensitivity, and efficiency. Thus, we believe that this dual electrode biosensor and the diagnostic plot could be used as a sensitive analytical tool for diagnosing glucose and lactate biomarkers in clinics and for monitoring obesity.

Assessment of iris vasculature abnormalities in dogs with diabetes mellitus.

To identify and characterize abnormalities of iris vasculature in dogs with diabetes mellitus, compared to clinically normal, age-matched control dogs, by means of anterior segment angiography. 10 dogs with naturally occurring diabetes mellitus and 10 age-matched control dogs with no ocular or systemic disease. The day before iris vasculature abnormality (IVA) assessment, all dogs underwent complete physical and ophthalmic examinations and baseline clinicopathologic analyses. For diabetic dogs, serum fructosamine concentration and a 12-hour blood glucose concentration curve were generated. The next day, all dogs were sedated and anterior segment angiography (following IV injection of indocyanine green [1 mg/kg] and subsequently sodium fluorescein [20 mg/kg]) was performed with a full-spectrum camera and camera adapter system. Group findings were compared, and multiple linear regression analysis was performed to identify potential factor associations with IVAs. During anterior segment angiography, the arterial, capillary, and venous phases were identified in all dogs. Times to onset of all phases in diabetic dogs were significantly less than those in control dogs. Vascular disruptions within the peripupillary region (evident following sodium fluorescein administration) were common in diabetic dogs. Severity of dye leakage into the iris stroma and aqueous humor was significantly greater in diabetic dogs than in control dogs. Duration of disease, mean blood glucose concentration, and serum fructosamine concentration were significantly associated with IVAs. In diabetic dogs, anterior segment angiography revealed IVAs that were not evident in control dogs. The severity of those changes appeared to be associated with disease duration and blood glucose regulation.

Blood glucose response after oral lactulose intake in type 2 diabetic individuals.

BACKGROUNDLactulose is approved for the symptomatic treatment of constipation, a gastrointestinal (GI) complication common in individuals with diabetes. Lactulose products contain carbohydrate impurities (e.g., lactose, fructose, galactose), which occur during the lactulose manufacturing process. These impurities may affect the blood glucose levels of individuals with type 2 diabetes mellitus (T2DM) using lactulose for the treatment of mild constipation. A previous study in healthy subjects revealed no increase in blood glucose levels after oral lactulose intake. However, it is still unclear whether the intake of lactulose increases blood glucose levels in individuals with diabetes.AIMTo evaluate the blood glucose profile after oral lactulose intake in mildly constipated, non-insulin-dependent subjects with T2DM in an outpatient setting.METHODSThis prospective, double-blind, randomized, controlled, single-center trial was conducted at the Clinical Research Center at the Medical University of Graz, Austria, in 24 adult Caucasian mildly constipated, non-insulin-dependent subjects with T2DM. Eligible subjects were randomized and assigned to one of six treatment sequences, each consisting of four treatments stratified by sex using an incomplete block design. Subjects received a single dose of 20 g or 30 g lactulose (crystal and liquid formulation), water as negative control or 30 g glucose as positive control. Capillary blood glucose concentrations were measured over a period of 180 min post dose. The primary endpoint was the baseline-corrected area under the curve of blood glucose concentrations over the complete assessment period [AUCbaseline_c (0-180 min)]. Quantitative comparisons were performed for both lactulose doses and formulations vs water for the equal lactulose dose vs glucose, as well as for liquid lactulose vs crystal lactulose. Safety parameters included GI tolerability, which was assessed at 180 min and 24 h post dose, and adverse events occurring up to 24 h post dose.RESULTSIn 24 randomized and analyzed subjects blood glucose concentration-time curves after intake of 20 g and 30 g lactulose were almost identical to those after water intake for both lactulose formulations despite the different amounts of carbohydrate impurities (≤ 3.0% for crystals and approx. 30% for liquid). The primary endpoint [AUCbaseline_c (0-180 min)] was not significantly different between lactulose and water regardless of lactulose dose and formulation. Also with regard to all secondary endpoints lactulose formulations showed comparable results to water with one exception concerning maximum glucose level. A minor increase in maximum blood glucose was observed after the 30 g dose, liquid lactulose, in comparison to water with a mean treatment difference of 0.63 mmol/L (95% confidence intervals: 0.19, 1.07). Intake of 30 g glucose significantly increased all blood glucose endpoints vs 30 g liquid and crystal lactulose, respectively (all P < 0.0001). No differences in blood glucose response were observed between the different lactulose formulations. As expected, lactulose increased the number of bowel movements and was generally well tolerated. Subjects experienced only mild to moderate GI symptoms due to the laxative action of lactulose.CONCLUSIONBlood glucose AUCbaseline_c (0-180 min) levels in mildly constipated, non-insulin dependent subjects with T2DM are not affected by the carbohydrate impurities contained in 20 g and 30 g crystal or liquid lactulose formulations.

Features of correction of a pathological condition of small animals at the diabetes mellitus with obesity

The article presents the results of clinical studies of domestic cats and dogs with diabetes mellitus on the background of obesity at the beginning and for a month of treatment. Domestic cats with diabetes were prescribed active exercise and industrial diet Royal Canin Diabetic Feline, dogs – Royal Canin Diabetic DS37. The portion size was determined according to the manufacturer's recommendations. Treatment of small animals for obesity, both alimentary and endocrine, preferably involves feeding food in limited quantities to cause controlled weight loss, as well as increased physical activity, which can provide additional energy expenditure. Successful weight loss can reduce the effects of comorbidities associated with obesity, such as improved mobility in osteoarthritis, increased insulin sensitivity and the reversal of other metabolic disorders, and improved quality of life. The main pathogenetic therapy for animals with diabetes for both domestic cats and dogs is the mandatory use of insulin. Researching the market of drugs in Ukraine, we chose the most affordable and effective veterinary drug – Caninsulin. The dose of insulin was selected individually for each animal by plotting a curve of blood glucose concentration over three days. At the beginning of treatment and at the end of the course, we conducted a comprehensive study of animals of both species. In cats, the general condition significantly improved as a result of treatment: only one animal remained depressed, the number of cases of hyporexia decreased, only 25.0 % of animals remained pale mucous membranes; temperature within the physiological norm; vomiting and bradycardia were not reported. A decrease in the rate of shortness of breath and drowsiness also indicates an improvement in the condition of cats with obesity due to diabetes. The improvement of the general condition of domestic dogs is evidenced by the restoration of the condition of the coat (about 4 times), the restoration of appetite in 66.7 %. Only one dog had anemia of the mucous membranes. Anxiety, bradycardia, hypothermia and itching disappeared completely. Within one month, there was a tendency to decrease the body weight of animals of both groups, but due to the insufficient duration of treatment, their fatness still remained excessive. Which indicates the need for further correction of the pathological condition.