Differences In Plasma Glucose Research Articles

Characterization of the zebrafish as a model of ATP-sensitive potassium channel hyperinsulinism

IntroductionCongenital hyperinsulinism (HI) is the leading cause of persistent hypoglycemia in infants. Current models to study the most common and severe form of HI resulting from inactivating mutations in the...

Effects of Saccharomyces cerevisiae boulardii (CNCM I-1079) on feed intake, blood parameters, and production during early lactation.

The periparturient period is a metabolically demanding time for dairy animals because of increased nutrient requirements for milk yield. The objective of this study was to investigate the effect of feeding Saccharomyces cerevisiae boulardii (CNCM I-1079), a commercial active dry yeast (ADY), in dairy cows on productive and metabolic measures during the periparturient period. Primiparous (n = 33) and multiparous (n = 35) cows were fed a close-up total mixed ration (TMR) before calving and a lactation TMR postpartum. Three weeks before expected calving time, animals were blocked by parity and body weight and then randomly assigned to either control group (control; n = 34) or treatment (ADY; n = 34). All animals were housed in a tie-stall barn with individual feed bunks; the ADY animals received supplementary Saccharomyces cerevisiae boulardii (CNCM I-1079), top dressed daily at a predicted dosage of 1.0 × 1010 cfu (12.5 g) per head. Blood samples were collected weekly along with milk yield and milk composition data; feed intake data were collected daily. Serum samples were analyzed for glucose, nonesterified fatty acid, β-hydroxybutyrate, haptoglobin (Hp), and the cytokines tumor necrosis factor-α, IL-6, and IL-18. Colostrum samples collected within the first 6 to 10 h were analyzed for somatic cell score and IgG, IgA, and IgM concentrations. Data were analyzed using PROC GLIMMIX in SAS with time as a repeated measure; model included time, parity, treatment, and their interactions. The ADY groups had greater milk yield (39.0 ± 2.4 vs. 36.7 ± 2.3 kg/d) and tended to produce more energy-corrected milk with better feed efficiency. There was no difference in plasma glucose, serum nonesterified fatty acid, serum β-hydroxybutyrate, Hp, IL-6, or IL-18 due to ADY treatment. The tumor necrosis factor-α increased in ADY-supplemented animals (1.17 ± 0.69 vs. 4.96 ± 7.7 ng/mL), though week, parity, and their interactions had no effect. Serum amyloid A tended to increase in ADY-supplemented animals when compared to control animals and was additionally affected by week and parity; there were no significant interactions. No difference in colostrum IgG, IgA, and IgM was observed between treatments. Supplementing transition cow TMR with ADY (CNCM I-1079) improved milk production and tended to improve efficiency in early lactation; markers of inflammation were also influenced by ADY treatment, though the immunological effect was inconsistent.

The Difference in Glucagon Response to Breakfast Between Non-Obese Patients With Long-Duration Type 1 and Type 2 Diabetes

Background: A balanced action of insulin and glucagon is essential for treating diabetes. This study aimed to assess the change in blood glucagon levels from fasting to a postprandial state and to compare them between patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM). Methods: This study enrolled patients with T1DM (n = 13) who had undetectable serum C-peptide levels (< 0.02 ng/mL) and patients with T2DM (n = 13) whose age, gender, and body mass index were matched to cases (1:1) as controls. Plasma glucose, serum C-peptide, and plasma glucagon in fasting and 2 h after consuming a standard breakfast for diabetic patients were measured and compared between groups. Results: There were no significant differences in plasma glucose and hemoglobin A1c levels between patients with T1DM and T2DM. However, fasting plasma glucagon levels were significantly lower in patients with T1DM than those in patients with T2DM (19.2 ± 13.0 pg/mL vs. 31.6 ± 18.3 pg/mL, P = 0.029). Furthermore, the glucagon’s response to a standardized meal for diabetic patients differed between patients with T1DM and T2DM. Conclusions: The significant difference in glucagon response to the meal may be caused by the abnormal postprandial secretion of glucagon in patients with T1DM. The nutrient ratio of the meal may also influence glucagon secretion. J Endocrinol Metab. 2022;12(4-5):134-139 doi: https://doi.org/10.14740/jem834

Central FGF21 production regulates memory but not peripheral metabolism.

SUMMARYFibroblast growth factor 21 (FGF21) is a liver-derived endocrine hormone that functions to regulate energy homeostasis and macronutrient intake. Recently, FGF21 was reported to be produced and secreted from hypothalamic tanycytes, to regulate peripheral lipid metabolism; however, rigorous investigation of FGF21 expression in the brain has yet to be accomplished. Using a mouse model that drives CRE recombinase in FGF21-expressing cells, we demonstrate that FGF21 is not expressed in the hypothalamus, but instead is produced from the retrosplenial cortex (RSC), an essential brain region for spatial learning and memory. Furthermore, we find that central FGF21 produced in the RSC enhances spatial memory but does not regulate energy homeostasis or sugar intake. Finally, our data demonstrate that administration of FGF21 prolongs the duration of long-term potentiation in the hippocampus and enhances activation of hippocampal neurons. Thus, endogenous and pharmacological FGF21 appear to function in the hippocampus to enhance spatial memory.

Effect of anthocyanin extract from Roselle,Hibiscus sabdariffa, calyx on haematological, biochemical and immunological parameters of rainbow trout,Oncorhynchus mykiss

In the present study, rainbow trout, Oncorhynchus mykiss, (14.1 ± 0.08 g) were fed diets supplemented with different levels of Roselle anthocyanin extract (RE) to assess the fish immune, stress and haematological parameters. For this, four levels of RE including 0, 0.5, 1 and 1.5% were added to the fish diet for eight weeks. Then, growth performance, blood haematological, biochemical, immunological and hepatic expression of cytokine genes were investigated in all treatments. At the end of the experiment, the fish exhibited similar growth rate and survival (final weight: 91.4–96.7 g; feed conversion ratio: 0.75–0.80; specific growth rate: 3.11–3.21% d−1; survival: 100%). The results showed that there were no significant differences in plasma glucose, cholesterol, triglyceride, total protein, albumin, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase and alkaline phosphatase levels among the treatments. Supplementation of the diets with 1% RE significantly increased RBC, haemoglobin, haematocrit, lysozyme, complement and WBC, compared with the control treatment. 1 and 1.5% RE significantly decreased plasma cortisol levels, compared with the control. All levels of dietary RE significantly up-regulated hepatic tumour necrosis factor-alpha gene expression, compared with the control treatment. 1 and 1.5% RE significantly up-regulated hepatic interleukin-1 beta gene expression, compared with the control treatment. 1.5% RE supplementation significantly down-regulated interleukin-10 gene expression, compared with the other treatments. In conclusion, dietary RE supplementation at 1% is beneficial for rainbow trout, as it mitigates stress and increases immune-related parameters.

A systems biology approach to understand gut microbiota and host metabolism in morbid obesity: design of the BARIA Longitudinal Cohort Study.

IntroductionPrevalence of obesity and associated diseases, including type 2 diabetes mellitus, dyslipidaemia and non‐alcoholic fatty liver disease (NAFLD), are increasing. Underlying mechanisms, especially in humans, are unclear. Bariatric surgery provides the unique opportunity to obtain biopsies and portal vein blood‐samples.MethodsThe BARIA Study aims to assess how microbiota and their metabolites affect transcription in key tissues and clinical outcome in obese subjects and how baseline anthropometric and metabolic characteristics determine weight loss and glucose homeostasis after bariatric surgery. We phenotype patients undergoing bariatric surgery (predominantly laparoscopic Roux‐en‐Y gastric bypass), before weight loss, with biometrics, dietary and psychological questionnaires, mixed meal test (MMT) and collect fecal‐samples and intra‐operative biopsies from liver, adipose tissues and jejunum. We aim to include 1500 patients. A subset (approximately 25%) will undergo intra‐operative portal vein blood‐sampling. Fecal‐samples are analyzed with shotgun metagenomics and targeted metabolomics, fasted and postprandial plasma‐samples are subjected to metabolomics, and RNA is extracted from the tissues for RNAseq‐analyses. Data will be integrated using state‐of‐the‐art neuronal networks and metabolic modeling. Patient follow‐up will be ten years.ResultsPreoperative MMT of 170 patients were analysed and clear differences were observed in glucose homeostasis between individuals. Repeated MMT in 10 patients showed satisfactory intra‐individual reproducibility, with differences in plasma glucose, insulin and triglycerides within 20% of the mean difference.ConclusionThe BARIA study can add more understanding in how gut‐microbiota affect metabolism, especially with regard to obesity, glucose metabolism and NAFLD. Identification of key factors may provide diagnostic and therapeutic leads to control the obesity‐associated disease epidemic.

Pharmacogenetic Evaluation of Metformin and Sulphonylurea Response in Mexican Mestizos with Type 2 Diabetes.

In Mexico, approximately 25% of patients with type 2 diabetes (T2D) have adequate glycemic control. Polymorphisms in pharmacogenetic genes have been shown to have clinical consequences resulting in drug toxicity or therapeutic inefficacy. The study aimed to evaluate the impact of variants in genes known to be involved in response to oral hypoglycemic drugs, such as CYP2C9, OCT, MATE, ABCA1 and C11orf65, in the Mexican Mestizo population of T2D patients. In this study, 265 patients with T2D were enrolled from the Hospital Juárez de México, Mexico City. Genotyping was performed by TaqMan® assays. SNP-SNP interactions were analyzed using the multifactor dimensionality reduction (MDR) method. Carriers of the del allele of rs72552763 could achieve better glycemic control than noncarriers. There was a significant difference in plasma glucose and HbA1c levels among rs622342 genotypes. The results suggested an SNP-SNP interaction between rs72552763 and rs622342 OCT1 and rs12943590 MATE2. The interaction between rs72552763 and rs622342 in OCT1, and rs12943590 in MATE2 suggested an important role of these polymorphisms in metformin response in T2D Mexican Mestizo population.

Estradiol and body weight during temporally targeted food restriction: Central pathways and peripheral metabolic factors

We used temporally-targeted food restriction (TTFR), in which ovariectomized rats had chow only for 2 h/day, to test the hypothesis that estradiol benzoate (EB) suppresses feeding and decreases body weight during brief (4 day) TTFR, as it does during ad libitum feeding. All rats lost weight during TTFR, but the loss was greater with EB treatment. However, OIL and EB-treated rats ate comparable amounts of chow during TTFR. We next investigated central nervous system pathways and peripheral hormonal and metabolic changes that accompany the effects of TTFR to determine the mechanism for this effect. Immunolabeling for fos in the nucleus of the solitary tract, the terminal site of vagal afferents from the gastrointestinal tract, was increased when rats on TTFR had access to chow for 1 h on the test day, indicating neuronal activation associated with consumption of the meal. However, fos immunolabeling was not affected by EB treatment, nor were numbers of the α subtype of estrogen receptors. TTFR had the expected effects on carbohydrate and lipid metabolites and metabolic hormones, with only slight differences in plasma glucose, triglycerides, and free fatty acids attributable to EB treatment. Interestingly, plasma corticosterone levels were greater in EB-treated rats on TTFR, and increased further after eating. Given that corticosterone affects metabolism, these findings suggest that elevated corticosterone may explain the persistence of EB-induced differences in body weight during TTFR despite the lack of effect on food intake.

Tale of two Indians: Heterogeneity in type 2 diabetes pathophysiology.

Type 2 diabetes is a heterogeneous disease and may manifest from multiple disease pathways. We examined insulin secretion and insulin resistance across two ethnicities with particularly high risk for diabetes yet with widely different distributions of weight class. In this population-based, cross-sectional study, Pima Indians from Southwestern United States (n=865) and Asian Indians from Chennai, India (n=2374) had a 75-g oral glucose tolerance test. We analysed differences in plasma glucose, plasma insulin, insulin resistance (HOMA-IR), and insulin secretion (ΔI0-30 /ΔG0-30 ) across categories of body mass index (BMI) and glycemic status per American Diabetes Association criteria. Pima Indians were younger (mean 27.4±SD 6.6, Asian: 33.9±6.7years) and had higher BMI (33.6±8.1, Asian: 25.7±4.9kg/m2 ). Among normal weight participants (mean BMI: Pima 22.4 SE 0.2; Asian 22.2 SE 0.06kg/m2 ), fasting glucose was higher in Asian Indians (5.2 vs Pima: 4.8mmol/L, P=.003), adjusted for age and sex. Pima Indians were three times as insulin resistant as Asian Indians (HOMA-IR: 7.7 SE 0.1, Asian: 2.5 SE 0.07), while Asian Indians had three times less insulin secretion (Pima: 2.8 SE 1.0 vs Asian: 0.9 SE 1.0pmol/mmol), a pattern evident across age, BMI, and glycemic strata. Metabolic differences between Pima and Asian Indians suggest heterogeneous pathways of type 2 diabetes in the early natural history of disease, with emphasis of insulin resistance in Pima Indians and emphasis of poor insulin secretion in Asian Indians.

2439-PUB: Ethnic Differences in Plasma Glucose on Emergency Admission to Hospital in People with No Prior Diagnosis of Diabetes

Objective: Glucose is measured on hospital admission as an emergency as elevated glucose is associated with an eight-fold risk of dying in hospital. This study reports on admission plasma glucose by ethnicity in people without prior diabetes. Research Design and Methods: A clinical audit CARMS-12031 of electronic patient records for 113,097 admissions to hospital over 1 year from April 2014 to March 2015 identified 43,201 emergency admissions with glucose unavailable for 11,274 (26%). Of 5,867 admissions with prior diabetes coding, 5,523 (94%) had glucose recorded. First attendances were analyzed for emergency admissions with no record of diabetes. Results: Of these 18,965 people admitted, 75% were White Europeans WE who were older than South Asians SA 12%, unknown/other ethnic groups U 9%, and Afro-Caribbeans AC 4%. 1,003 people admitted as an emergency had glucose in ‘diabetes range’ (≥11.1mmol/L) and 3,042 in ‘at risk’ range (7.8 to 11.0mmol/L). More SA 8% had glucose in diabetes range than WE 5% and also than U 5%; there were significantly more WE 17% in ‘at risk’ range than U 14% or AC 11%. Higher glucose was observed in SA and U men than women, p = 0.005 and p = 0.018, respectively. Conclusions: Protocols should target people requiring additional HbA1c testingto diagnose undiagnosed diabetes on hospital admission especially younger SA and AC individuals, and outline appropriate clinical intervention. Disclosure S. Ghosh: Advisory Panel; Self; Abbott. Other Relationship; Self; Mylan. R. Susarla: None. R.A. Round: None. P. Nightingale: None. J.A. Williams: None. I.M. Stratton: Consultant; Self; Novo Nordisk A/S. Research Support; Self; Bayer AG, Boehringer Ingelheim International GmbH. G. Gkoutos: None. J. Webber: None. W. Hanif: Advisory Panel; Self; Boehringer Ingelheim International GmbH. Consultant; Self; Novo Nordisk A/S. Research Support; Self; AstraZeneca, Janssen Diagnostics, Sanofi. Speaker's Bureau; Self; AstraZeneca, Novartis AG, Novo Nordisk A/S. G. Roberts: None. S.E. Manley: None.

1318-P: Fructose Consumption Contributes to Hyperinsulinemia in Obese Adolescents through a GLP-1-Mediated Mechanism

Background: The consumption of high-fructose beverages is associated with higher risk for T2D. Fructose can stimulate GLP-1 secretion in lean adults, in the absence of any inhibitory effect on appetite. We hypothesized that the ingestion of glucose (GLC) and fructose (FRU) may differentially stimulate GLP-1 and insulin response in lean and obese adolescents. Methods: We studied 14 lean (4F, 15.9±1.6y, 21.8±2.2 kg/m2) and 23 obese (5F, 15.1±1.6y, 34.5±4.6 kg/m2) adolescents. Participants received, in a double blinded cross-over study, 75g of GLC or FRU. Plasma was obtained every 10min for 60 minutes GLC was determined by YSI Analyzer; insulin and GLP-1 were measured by Millipore RIA; data were expressed as incremental values from baseline and compared by linear mixed effect model between lean and obese. Results: Obese adolescents exhibited greater insulin (p<0.001) and GLP-1 (p<0.001) rise after FRU than lean peers, at each time points (Figure), in the absence of a significant difference in plasma GLC (p0.699). After GLC ingestion, neither the rise in plasma GLC (p0.099), nor in insulin (p0.099) and GLP-1(p0.083) differed between lean and obese youths. Conclusion: Fructose, but not glucose, ingestion elicits higher insulin and GLP-1 response in obese as compared to lean adolescents. High-fructose consumption may contribute to the hyperinsulinemic phenotype through a GLP-1 mediated mechanism. Disclosure A. Galderisi: None. M.A. Van Name: Research Support; Self; Novo Nordisk Inc. C. Giannini: None. M. Savoye: None. S. Caprio: None. Funding National Institutes of Health (1R01DK085577-01, R01HD40787, R01HD28016; P30DK045735, K12DK094714-02; R01DK111038-01A1; Pediatric Endocrine Society; Robert E. Leet and Clara Guthrie Patterson Trust; European Medical International Framework (EMIF115372)

The impact of differences in plasma glucose between glucose oxidase and hexokinase methods on estimated gestational diabetes mellitus prevalence

We evaluated the extent of measurement discordance between glucose oxidase and hexokinase laboratory methods and the effect of this on estimated gestational diabetes mellitus (GDM) prevalence in a routine clinical setting. 592 consecutive urban African women were screened for GDM. Paired venous specimens were submitted to two independent calibrated laboratories that used either method to measure plasma glucose concentrations. World Health Organisation diagnostic criteria were applied. GDM prevalence determined by the glucose oxidase and hexokinase methods was 6.9% and 5.1% respectively. The overall GDM prevalence was 9%. Only 34% of GDM positive diagnoses were common to both laboratory methods. Bland Altman plots identified a bias of 0.2 mmol/l between laboratory methods. Plasma glucose concentrations measured by the glucose oxidase method were more platykurtic in distribution. Low diagnostic agreement between laboratory methods was further indicated by a Cohen’s kappa of 0.48 (p < 0.001). Reports of GDM prevalence using either the glucose oxidase or hexokinase laboratory methods may not be truly interchangeable or directly comparable.

Prepartum fatty acid supplementation in sheep. III. Effect of eicosapentaenoic acid and docosahexaenoic acid during finishing on performance, hypothalamus gene expression, and muscle fatty acids composition in lambs.

The objectives of this study were to evaluate the effect of feeding an enriched diet with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) to finishing lambs born from ewes supplemented either with or without EPA and DHA during late gestation on productive performance, muscle fatty acid (FA), and hypothalamus mRNA concentration of metabolic genes and hormone receptors. Lambs born from dams fed during the last 50 d of gestation either with a control diet containing 0.39% Ca salts of palmitic fatty acid distillate (C) or Ca salts enriched with EPA and DHA (PFA) were used. After weaning lambs (n = 70) were blocked by weight (BW) and used in a 2 × 2 factorial into 2 finishing diets containing 1.5% of C or PFA. The 2 factors were the ewe diet and the finishing diet. Lambs (37.9 ± 0.4 kg) were weighed and blood sampled for glucose and NEFA measurements at days 1, 14, 28, and 42. Dry matter intake (DMI) was measured daily. At day 43, 14 females and 14 males were slaughtered, and hot carcass weight, body wall thickness, rib eye area, and FA composition of Longissumus thoracis muscle were evaluated. Female hypothalamuses were obtained and mRNA concentration of hormone receptors, neuropeptides, and their receptors was measured. Lambs born from PFA dams were heavier (P < 0.01). There was a time × finishing diet interaction for BW (P = 0.03), and lambs fed C had a greater BW. Lambs fed C had an increase in DMI (P < 0.01). There were no significant differences in plasma glucose and NEFA concentration (P > 0.1). Lambs born from PFA dams had a greater concentration of C22:0 (P < 0.03). Lambs fed C had higher concentrations of C18:1c15 (P < 0.01), C17:0 (P < 0.09), C18:0 (P < 0.09), and n6/n3 (P < 0.01). Lambs fed PFA had greater concentration (P < 0.05) of C16:1, C22:1, C20:5, C22:5, C22:6, total n3 FA, and total EPA and DHA. There was a significant dam × finishing diet interaction (P ≤ 0.08) on mRNA concentration for MCR3, CCK-R, Cort-R, and CART. Lambs, which had the same treatment as their dams, showed lower overall mRNA concentration than those with different treatments between them and their dams. Lambs born from PFA ewes had lower concentration of MCR4 mRNA (P = 0.09) than C. Agouti-related peptides mRNA concentration was lower in lambs fed PFA (P = 0.06) than C. In conclusion, changes on lamb performance, muscle fatty acid composition, and metabolic neuropeptides depend not only on the lamb diet, but also on the dam diet during late gestation.

Cardioprotective effects of dietary rapamycin on adult female C57BLKS/J-Leprdb mice.

Rapamycin (RAPA), an inhibitor of mTORC signaling, has been shown to extend life span in mice and other organisms. Recently, animal and human studies have suggested that inhibition of mTORC signaling can alleviate or prevent the development of cardiomyopathy. In view of this, we used a murine model of type 2 diabetes (T2D), BKS-Leprdb , to determine whether RAPA treatment can mitigate the development of T2D-induced cardiomyopathy in adult mice. Female BKS-Leprdb mice fed diet supplemented with RAPA from 11 to 27 weeks of age showed reduced weight gain and significant reductions of fat and lean mass compared with untreated mice. No differences in plasma glucose or insulin levels were observed between groups; however, RAPA-treated mice were more insulin sensitive (P < 0.01) than untreated mice. Urine albumin/creatinine ratio was lower in RAPA-treated mice, suggesting reduced diabetic nephropathy and improved kidney function. Echocardiography showed significantly reduced left ventricular wall thickness in mice treated with RAPA compared with untreated mice (P = 0.02) that was consistent with reduced heart weight/tibia length ratios, reduced myocyte size and cardiac fibrosis measured by histomorphology, and reduced mRNA expression of Col1a1, a marker for cardiomyopathy. Our results suggest that inhibition of mTORC signaling is a plausible strategy for ameliorating complications of obesity and T2D, including cardiomyopathy.

Leukocyte profile, gene expression, acute phase response, and metabolite status of cows with sole hemorrhages

Sole hemorrhages result from disruption to normal claw horn formation and are caused by a variety of internal and external factors. Evidence suggests that they are painful, although they do not usually cause clinical lameness and are difficult to detect by observing cow gait. Little is known about how or whether sole hemorrhages affect the cow systemically. This study compared hematology profile, leukocyte gene expression, and physiological responses of cows with no/mild hemorrhages (category 1; n = 17), moderate hemorrhages (category 2; n = 18), and severe hemorrhages (category 3; n = 12). At approximately 100 d in milk, all cows in the study herd (n = 374) were locomotion scored before hoof examination. The cows included in the study were not clinically lame and had no other hoof disorder. Blood samples were taken from all cows within 24 h of selection. Leukocyte counts were obtained using an automated cell counter, cortisol and dehydroepiandrosterone (DHEA) concentration by ELISA, and plasma haptoglobin, urea, total protein, creatine kinase and glucose were analyzed on a clinical chemistry analyzer. Expression of 16 genes associated with lameness or stress were estimated using real-time quantitative PCR. Data from cows within each category were compared using the Mixed procedure in SAS (version 9.3; SAS Institute Inc., Cary, NC). Fixed effects included hemorrhage severity category and lactation number, with days in milk and body condition score included as covariates. Locomotion score worsened as sole hemorrhage category worsened. Locomotion score of category 1 cows tended to be lower than that of category 2 cows and was lower than that of category 3 cows. The locomotion score of category 3 cows was also greater than that of categories 1 and 2 combined. Category had no effect on leukocyte number, on any of the individual leukocyte cell numbers or percentages, cortisol or DHEA concentration, cortisol:DHEA ratio, or relative expression of any of the genes investigated, and we detected no differences in plasma glucose, protein, or creatine kinase concentrations between categories. However, category 3 cows had greater plasma concentrations of haptoglobin and tended to have lesser concentrations of plasma urea than category 1 and 2 cows. The differences in gait between cows with no or minor sole hemorrhages and cows with severe hemorrhages indicate that hemorrhages may be associated with discomfort or pain. Nevertheless, the only physiological measure that changed with increasing locomotion score was plasma haptoglobin concentration. Haptoglobin has previously been found to be elevated in lame cows, and thus shows promise as a marker for limb pain.

The incidence of asymptomatic hypoglycemia in term newborn babies weighing more than two kilograms

Background: Neonatal hypoglycemia is a common metabolic problem especially in cases like prematurity, sepsis and small gestational age. Episodes of asymptomatic hypoglycemia may occur due to many risk factors. The present study aimed to evaluate the incidence of asymptomatic hypoglycemia in term new born babies weighing more than 2 kg, to study the plasma sugar level at various time points during first 48 hours of life and to study the effect of maternal factors like parity, mode of delivery, glucose infusion during labour, and time since last feed on plasma sugar level.Methods: A hospital based longitudinal study was conducted over a period of one year from April 2005 to March 2006 in Kilpauk Medical College Hospital, Chennai. 400 babies born of consecutive deliveries were included in the study. Their plasma glucose levels were assessed in cord blood, 3 hr, 12 hr and 36 hr of life. Plasma glucose levels were analysed with regards to distribution, variables like parity, mode of delivery, dextrose infusion during labour and time since last feed. The plasma glucose levels were statistically analysed by paired student ‘t’ test, multiple analysis of variance (ANOVA), chi- square test using SPSS (version 7.5) statistical package.Results: The overall incidence of hypoglycemia was seen in 20% of the neonate’s in which 29.7% in small gestational age (SGA) and 16.7% in appropriate gestational age (AGA) babies. A significant (p &lt;0.01) association between hypoglycemia and birth weight was observed. The association between hypoglycemia with parity, mode of delivery, sex of the baby and glucose infusion received by the mother was studied, but no significant association was found. A significant difference in plasma glucose based on birth weight at 3rd hour, 12th hour and 36th hour was observed (p &lt;0.05). None of the infants showed any clinical signs of hypoglycemia.Conclusions: The incidence of hypoglycemia was noted in 20% of the neonates. Low birth weight was considered as risk factor. A significant association was also observed between plasma glucose, mode of delivery and time since last fed.

Glucose, Insulin and Metabolic Response to Soy and Whey Protein among Normal Healthy Weight Indians

INTRODUCTIONHigh quality dietary protein intake has been linked to the healthy growth and development of lean tissue. Both milk and legumes are recognized as high quality protein sources. However, the acute effect of consumption of different sources and amounts of high quality protein on glucose homeostasis, particularly in South Asian Indians, is unknown. This is relevant in this population group, which has a greater risk of developing diabetes, and a habitually low intake of high quality protein.METHODSThis study investigated the effect of milk (whey) and legume‐based (soy) protein on glucose homeostasis and energy metabolism, among healthy normal weight Indians. The study tested protein type (soy protein vs. whey protein) and dose (15% vs. 30% Energy). Healthy adult males between ages of 20–35 years (n=15) received four test meals in random order. Blood samples were collected at the following time points Basal (−10 and −5 min), and post meal (15, 30, 45, 60, 90, 120,180, 240 and 300 min) for glucose and insulin estimations. The incremental area under the curve was measured for plasma glucose and insulin. Energy expenditure and substrate oxidation were measured every 30 minutes for 300 minutes after the meal. Satiety was estimated using visual analogue scale at 0, 10, 40 min, and every half hour thereafter.RESULTSThe incremental area under the curve for plasma insulin was significantly higher for 30% whey compared to 30% soy protein (p&lt;0.01). There was no difference in the insulinogenic response between 15% whey and 15% soy protein (p=0.07). Within a specific protein, only whey protein demonstrated a higher insulin response with a higher dose (p&lt;0.01). There were no differences in plasma glucose across protein source or doses. Satiety and energy expenditure did not differ between protein source and doses.CONCLUSIONAt lower doses, whey and soy protein do not elicit different insulinogenic responses. However, at higher doses whey protein has greater insulinogenic response compared to soy protein, making soy protein a better source for those at greater risk for developing diabetes.Support or Funding InformationDuPont Nutrition &amp; Health

Identifying hyperinsulinaemia in the absence of impaired glucose tolerance: An examination of the Kraft database

ObjectiveHyperinsulinaemia is associated with development of chronic metabolic disease and is emerging as a health risk independent to that of insulin resistance. However, little is known to what extent hyperinsulinaemia occurs with normal glucose tolerance in lean subjects. MethodOral glucose tolerance tests with concurrent insulin assay were conducted during the 1970s–1990s. Participants were classified according to glucose tolerance and insulin response pattern. Analysis of variance compared differences in plasma glucose, plasma insulin, and demographic and metabolic risk factors between groups. ResultsParticipants with normal glucose tolerance comprised 54% (n=4185) of the total cohort. Of these, just over half (n=2079) showed hyperinsulinaemia despite normal glucose clearance. Obesity had a modest association with hyperinsulinaemia in people with normal glucose tolerance. Fasting insulin had limited value in diagnosing hyperinsulinaemia. The majority of participants (93%) with impaired glucose tolerance or diabetes had concurrent hyperinsulinaemia. ConclusionHyperinsulinaemia in the absence of impaired glucose tolerance may provide the earliest detection for metabolic disease risk and likely occurs in a substantial proportion of an otherwise healthy population. Dynamic insulin patterning may produce more meaningful and potentially helpful diagnoses. Further research is needed to investigate clinically useful hyperinsulinaemia screening tools.

Effect of Vitamin D Fortified Cheese on Oral Glucose Tolerance in Individuals Exhibiting Marginal Vitamin D Status and an Increased Risk for Developing Type 2 Diabetes: A Double‐Blind, Randomized Placebo‐Controlled Clinical Trial

Epidemiological data suggest that vitamin D may play a role in glucose metabolism and homeostasis, and that it maybe particularly important for individuals at an increased risk for developing type 2 diabetes mellitus (T2DM).ObjectiveWe conducted a double‐blind, randomized, placebo‐controlled trial to examine the effects of 28,000 IU of vitamin D3 given in cheese once per week versus placebo on the 2hr oral glucose tolerance test (OGTT) and measures of insulin sensitivity, secretion and β‐cell function.Study DesignPotential participants were identified as being at an increased risk for developing diabetes using the Finnish Diabetes Risk Score (FINDRISC) questionnaire. Participants who were vitamin D deficient (serum 25‐hydroxy vitamin‐D [25(OH)D] ≤65nmol/L) and who had elevated glycated hemoglobin (HbA1c) between 5.4 and 6.4% and/or fasting glucose between 5.6 and 6.9 mmol/L were randomized to receive 28,000 IU of vitamin D3 or placebo (20 IU) once weekly for a period of 24 weeks. The primary outcome of interest was the difference in plasma glucose 2hr after an OGTT between baseline and 24 wks. Secondary outcomes include fasting glucose, fasting and postprandial insulin and indices of insulin sensitivity (Matsuda Index), secretion (insulinogenic index), β–cell function (ISSI‐2) and long‐term glycemic status (HbA1c). Data were analyzed by intention‐to‐treat.ResultsSeventy‐one participants (mean age 47.4) were randomized and sixty‐three completed the trial. Supplementation produced a significant increase in serum 25(OH)D in the vitamin D group (n= 35) versus placebo (n=36) (103.6±36.5 vs. 46.4±18.9 nmol/ L, p &lt;0.0001). After 24 wks of supplementation 74% of participants in the vitamin D group achieved 25(OH)D levels ≥75nmol/Lvs6% in the placebo group. Supplementation produced no significant improvements in fasting (p=0.89) and glucose 2hr after the OGTT (p= 0.88), fasting (p= 0.28) and postprandial (p= 0.77) insulin, HbA1c (p=0.34), HOMA‐IR (p= 0.32), Matsuda Index (p=0.72), and ISS1‐2 (p=0.86).ConclusionWeekly doses of 28,0000 IU of vitamin D3 for 24 wks in a group of multi‐ethnic, vitaminD–deficient individuals identified as being at high risk for developing T2DMdid not improve oral glucose tolerance, insulinsensitivity, β–cell function or HbA1c.Support or Funding InformationResearch funded by the Dairy Farmers of Canada and the Public Health Agency of Canada.

Effects of supplementing a milk replacer with sodium butyrate or tributyrin on performance and metabolism of Holstein calves

The effects of butyrate supplementation in diets of calves are inconsistent in the literature. Fifty-one Holstein calves (45.7 ± 5.8 kg of bodyweight and 11.8 ± 3.1 days of age; mean ± s.d.) were randomly allocated to three treatments to assess the effects of supplementing the milk replacer at 0.3% dry matter with butyrate in the form of sodium butyrate or tributyrin compared with no supplementation (CTR). Calves were fed 4 L/day of milk replacer (25% crude protein and 19.2% ether extract) and starter feed (20% crude protein and 3.8% ether extract) ad libitum over a period of 6 weeks. Individual intake was measured daily and bodyweight and blood β-hydroxybutyrate, glucose-like peptide-1, glucose and insulin were measured fortnightly. A glucose tolerance test was performed on Days 0 and 35 of the study. No effects of butyrate supplementation were found on starter and total dry matter intake. CTR calves had greater average daily gain than tributyrin calves. CTR calves tended to have greater final bodyweight than tributyrin and sodium butyrate calves. Gain : feed ratio tended to be greater for CTR calves. There were no differences in plasma glucose, insulin, β-hydroxybutyrate and glucose-like peptide-1 concentrations throughout among treatments the study. During the glucose tolerance test, no differences on insulin sensitivity were found among treatments. In conclusion, no apparent advantages of supplementing milk replacer with sodium butyrate or tributyrin were found on performance and glucose metabolism in calves.