Glucose Metabolism In Individuals Research Articles

Comparison of acute glucose responses following combined arm and leg cycling in non and pre-diabetic males

Prolonged and chronic sedentary behavior contributes to negative metabolic health conditions. Recent research has shown that a single bout of combined arm and leg cycling (CALC) can improve acute glucose metabolism in non-diabetic college aged adults. If a short bout of CALC can improve glucose metabolism in individuals that are non-diabetic then one could hypothesize that a short bout of CALC may improve glucose metabolism in individuals that are pre-diabetic. We hypothesized that short bouts of CALC would result in a greater decrease in the 60-min total (tAUC) area under the curve in pre-diabetic compared to non-diabetic males. PURPOSE: To compare acute glucose responses following a short bout of CALC in non and pre-diabetic males. METHODS: College age males were recruited for this trial. Diabetes status was based upon a fasting blood glucose measurement taken after an overnight 12 hour fast. Participants completed three randomized experimental trials. Two of the experimental trials consisted of a 1-min (1M) or 5-min (5M) bout of CALC at a self-selected pace. The third trial was a non-exercise control (CON) trial. Immediately following both exercise trials and during the CON trial, participants completed a 60-min oral glucose tolerance test. A 2-way (diabetes status vs trial) repeated measures ANOVA was done to determine if there were any significant differences between the two groups and the three trials for the tAUC during the 60-min OGTT. RESULTS: A total of 18 college age males completed this study. Fasting blood glucose was 94.0 ± 3.7 and 108.1 ± 4.6 mg/dl for the non (n=8, 21.4 ± 2.4 yrs) and pre-diabetics (n = 10, 22.6 ± 3.9 yrs) participants respectively. There was a significant interaction between trials and diabetes status (p = 0.04) for tAUC. Follow-up analysis showed that within the pre-diabetic group, tAUC was significantly lower in the 5-min trial compared to the CON trial (113.7 ± 22.5 mg/dl, p > 0.001). Within the pre-diabetic group, the tAUC for the 1M trial was not significantly different from the CON or 5M trials. Within the non-diabetic group, there were no significant differences in tAUC between the three trials. CONCLUSIONS: The results of this study indicate that a 5M bout of CALC done at a self-selected pace may have the ability to acutely improve glucose metabolism in college age pre-diabetic males when compared to non-diabetic males. Supported by a SIUE Graduate School Research Grant for Graduate Students, the School of Education, Health, and Human Behavior Dean's Grant, and the Undergraduate Research and Creative Activities Program. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Effect of resveratrol on insulin action in primary myotubes from lean individuals and individuals with severe obesity.

Resveratrol, a natural polyphenol compound contained in numerous plants, has been proposed as a treatment for obesity-related disease processes such as insulin resistance. However, in humans there are conflicting results concerning the efficacy of resveratrol in improving insulin action; the purpose of the present study was to determine whether obesity status (lean, severely obese) affects the response to resveratrol in human skeletal muscle. Primary skeletal muscle cells were derived from biopsies obtained from age-matched lean and insulin-resistant women with severe obesity and incubated with resveratrol (1 µM) for 24 h. Insulin-stimulated glucose oxidation and incorporation into glycogen, insulin signal transduction, and energy-sensitive protein targets [AMP-activated protein kinase (AMPK), Sirt1, and PGC1α] were analyzed. Insulin-stimulated glycogen synthesis, glucose oxidation, and AMPK phosphorylation increased with resveratrol incubation compared with the nonresveratrol conditions (main treatment effect for resveratrol). Resveratrol further increased IRS1, Akt, and TBC1D4 insulin-stimulated phosphorylation and SIRT1 content in myotubes from lean women, but not in women with severe obesity. Resveratrol improves insulin action in primary human skeletal myotubes derived from lean women and women with severe obesity. In women with obesity, these improvements may be associated with enhanced AMPK phosphorylation with resveratrol treatment.NEW & NOTEWORTHY A physiologically relevant dose of resveratrol increases insulin-stimulated glucose oxidation and glycogen synthesis in myotubes from individuals with severe obesity. Furthermore, resveratrol improved insulin signal transduction in myotubes from lean individuals but not from individuals with obesity. Activation of AMPK plays a role in resveratrol-induced improvements in glucose metabolism in individuals with severe obesity.

Unraveling the Therapeutic Potential of Muscle Strengthening Exercises for Reversing Diabetes Mellitus.

Millions of people worldwide are affected by the serious consequences of diabetes mellitus, which is a major global health concern. We analyze the possibility of muscle- strengthening activities as an appropriate therapeutic strategy for controlling the progression of diabetes mellitus in this comprehensive review. In this review, we explore the molecular processes underlying the glucose uptake in skeletal muscle, revealing how exercise can improve insulin sensitivity and glucose homeostasis. Articles published between 2010 and 2023 were analyzed in detail by using bibliographic databases like PubMed, Medline, and Scopus. The most commonly searched terms were "muscle strengthening exercises," "diabetes mellitus," "insulin resistance," "glucose uptake," "skeletal muscle," and even "exercise therapy." The inclusion criteria were randomized controlled trials, observational studies, and systematic reviews. This allowed for the selection of sources that were related to the topic at hand and were reliable. This review highlights the benefits of exercise for diabetes mellitus, elucidating the positive effects of acute and regular exercise on glucose uptake in skeletal muscle. It also analyzes the impact of various exercise modalities, including aerobic and resistance exercises, on glucose metabolism in individuals with and without type 2 diabetes. Furthermore, this review examines the effectiveness of combining aerobic and resistance training for optimal diabetes management. Our analysis reveals promising evidence supporting the role of resistance training in diabetes mellitus reversal. Regular resistance exercise has been shown to improve glycemic control, insulin sensitivity, and muscle function in individuals with type 2 diabetes. Combining aerobic and resistance exercises appears to be more effective than single-mode training in managing blood glucose levels and enhancing overall metabolic health. However, Resistance training implementation challenges, as well as potential exercise contraindications in diabetic patients, warrant further studies.

SYMBIOSIS OF HEALTH: UNRAVELING THE RELATIONSHIPS AMONG INTERLEUKIN-10, CHOLESTEROL, AND BLOOD GLUCOSE LEVELS IN GEOHELMINTH-POSITIVE ADOLESCENTS AND ADULTS - A COMPARATIVE STUDY

This comparative study delves into the intricate relationships among interleukin-10 (IL-10), cholesterol levels, and blood glucose levels ingeohelminth-positive adolescents and adults. Geohelminth infections, prevalent in many regions, present a unique context to explore the immunomodulatory effects on IL-10 and its potential impact on metabolic parameters. Utilizing a comprehensive approach,the research aims to unravel the symbiotic dynamics between immune response, cholesterol regulation, and glucose metabolism in individuals harboring geohelminth infections. Insights from this study hold promise for understanding the interplay between parasitic infections and metabolic health.

Glucose metabolism and autonomic function in healthy individuals and patients with type 2 diabetes mellitus at rest and during exercise.

Autonomic dysfunction is a common complication of type 2 diabetes mellitus (T2DM). However, the character of dysfunction varies in different reports. Differences in measurement methodology and complications might have influenced the inconsistent results. We sought to evaluate comprehensively the relationship between abnormal glucose metabolism and autonomic function at rest and the response to exercise in healthy individuals and T2DM patients. We hypothesized that both sympathetic and parasympathetic indices would decrease with the progression of abnormal glucose metabolism in individuals with few complications related to high sympathetic tone. Twenty healthy individuals and 11 T2DM patients without clinically evident cardiovascular disease other than controlled hypertension were examined. Resting muscle sympathetic nerve activity (MSNA), heart rate variability, spontaneous cardiovagal baroreflex sensitivity (CBRS), sympathetic baroreflex sensitivity and the MSNA response to handgrip exercise were measured. Resting MSNA was lower in patients with T2DM than in healthy control subjects (P=0.011). Resting MSNA was negatively correlated with haemoglobin A1c in all subjects (R=-0.45, P=0.024). The parasympathetic components of heart rate variability and CBRS were negatively correlated with glycaemic/insulin indices in all subjects and even in the control group only (all, P<0.05). In all subjects, the MSNA response to exercise was positively correlated with fasting blood glucose (R=0.69, P<0.001). Resting sympathetic activity and parasympathetic modulation of heart rate were decreased in relationship to abnormal glucose metabolism. Meanwhile, the sympathetic responses to handgrip were preserved in diabetics. The responses were correlated with glucose/insulin parameters throughout diabetic and control subjects. These results suggest the importance of a comprehensive assessment of autonomic function in T2DM.

Plasma biomarkers of Alzheimer’s Disease associate with gray matter volume and cerebral glucose metabolism in older adults with Mild Cognitive Impairment

AbstractBackgroundAlzheimer’s Disease (AD) pathology in vivo has traditionally been measured in the cerebrospinal fluid or by positron emission tomography (PET). Developments in measuring plasma biomarkers present less invasive, cheaper ways to quantify AD pathology. However, the associations between these new plasma markers and neuroimaging markers of AD are not fully understood. We examined the relationship between plasma biomarkers of AD and measures of whole brain gray matter volume (GMV) and cerebral glucose metabolism in both cognitively unimpaired (n = 83) and impaired (n = 30) individuals.MethodWe collected data from individuals within the University of Kansas Alzheimer’s Disease Research Center’s (KU ADRC) Clinical Cohort who underwent MRI and FDG‐PET scans and had available plasma data. Participants included 64 females, and age of the neuroimaging cohort was 76.0 ± 6. Plasma biomarkers were measured in EDTA plasma using the Quanterix Simoa® HD‐X, and included NfL, Aβ42, Aβ40, GFAP, and p‐tau181. GMV was estimated using MPRAGE MRI processed in FreeSurfer. Cerebral glucose metabolism was estimated from FDG‐PET data using SUVR values calculated through SPM12, with standardization to pons. We used linear regression to examine the relationship between each biomarker to whole brain GMV and glucose metabolism. ANCOVA was used to evaluate differences in the plasma biomarkers between diagnosis groups. Analyses included sex and age as covariates.ResultWhole brain GMV (F = 8.4, p = .004) and cerebral glucose metabolism (F = 10.9, p = .002) differed between diagnostic groups. In the linear regression, we observed an interaction effect between cognitive diagnosis and each biomarker, such that the slopes of regressions between each plasma biomarker and neuroimaging marker was significant in the impaired group, but not significant in the unimpaired. In the impaired group, the strongest association observed was between plasma NFL and whole brain GMV (β = ‐1.4, p = .020) and cerebral glucose metabolism (β = ‐1.7, p = .014). Additionally, all plasma biomarkers were found to differ between diagnostic groups.ConclusionWe show that plasma markers of AD pathology associate with whole brain GMV and cerebral glucose metabolism in individuals with cognitive impairment. Further work will examine the relationship between biomarkers and regional neuroimaging measures

Abstract 149: Metabolic Neuroimaging in the Assessment of Cardiovascular Risk: A Regional FDG‐PET Analysis

Introduction Emerging evidence suggests a robust association between cardiovascular disease (CVD) and cognitive decline, accentuating the necessity for early detection and intervention. 18F‐fluorodeoxyglucose‐positron emission tomography (FDG‐PET) has proven efficacious in identifying metabolic neurological changes at a molecular level, even before conventional imaging methods can detect structural changes. This study analyzed regional glucose metabolism in individuals with known CVD risk factors. The detection of such metabolic changes could assist in determining the necessity and timing of vascular interventions, such as carotid endarterectomy (CEA) or carotid artery angioplasty with stenting (CAS), contributing to improved patient outcomes and reduced postoperative complications. Methods We compared 79 healthy controls (mean age 44.5 ± 13.8 years, 53.2% males) and 40 individuals (mean age 55.9 ± 11.9 years, 50% males) at increased risk for cardiovascular disease (CVD) as assessed by the systematic coronary risk evaluation tool. All subjects were grouped into two age‐matched cohorts: younger (&lt;45 years) and older (≥45 years). All subjects underwent whole‐body FDG‐PET/CT imaging. The quantitative regional analysis of PET images was performed using MIMneuro version 7.1.5 (MIM Software, Inc., Cleveland, Ohio). 70 neurological structures were analyzed in each subject. An independent samples t‐test was used to assess the differences in z‐scores between controls and at‐risk subjects. The threshold for significance was set at P &lt; 0.05. Results Within the younger cohort, the cingulate gyrus (p=0.0206) and the anterior cingulate gyrus (p=0.0348) demonstrated significant hypometabolism in patients with known cardiac risk factors when compared to healthy controls. Within the older cohort, the supplementary motor area demonstrated significant hypometabolism (p=0.0145), while both the pons (p=0.0169) and pontine tegmentum (p=0.0063) had significant hypermetabolism in patients with known cardiac risk factors when compared to healthy controls. Conclusion Our analysis revealed an inverse relationship between increased cardiovascular disease risk and metabolic activity, particularly in three brain regions: the cingulate gyrus, the anterior cingulate gyrus, and the supplementary motor area. The findings substantiate the vulnerability of the cingulate gyrus to the impacts of small vessel disease. Hypoperfusion, a potential consequence of atherosclerotic plaque accumulation in the perfusing artery, engenders a pernicious cycle of hypoxia, oxidative stress, mitochondrial dysfunction, and inflammation, which exacerbates neuronal cell death. The cingulate gyrus, vascularized by the pericallosal arteries (branches of the anterior cerebral artery from the internal carotid arteries), and the pontine tegmentum, supplied by branches of the basilar artery, are pivotal in this context. Calcification within these arteries could potentially instigate decreased perfusion, thereby contributing to the observed hypometabolism. Examining microstructural and functional changes in the neurovascular system in response to cardiovascular disease risk factors provides key insights. These findings could inform targeted interventions, streamline perioperative strategies, and aid in decision‐making regarding the timing of vascular interventions. Future studies investigating the association among arterial calcification, regional hypometabolism, and cognitive decline may provide a deeper understanding of the complex interplay between cardiovascular health and cognitive function, supporting the improvement of intervention strategies and refinement surgical techniques.

Thigh muscle fat fraction is independently associated with impaired glucose metabolism in individuals with obesity.

The aim of this study was to address the intramuscular adipose tissue (IMAT) accumulation in the lower extremities and further detect the relationship between adipose tissue (AT) distribution in the muscle and glucose metabolism in subjects with obesity. We conducted a cross-sectional study in 120 Chinese obese adults (80 male and 40 female) with BMI ≥ 28 kg/m2. MRI was applied to access the IMAT content in lower extremities. The oral glucose tolerance test was used to evaluate the glucose metabolism and insulin secretion in all individuals. The correlations between glucose metabolism and the fat content of the lower extremities were further assessed. Among 120 included subjects, 54 were classified as subjects with normal glucose tolerance (NGT) and 66 with impaired glucose regulation (IGR). We presented that those with IGR had higher fat accumulation in semitendinosus, adductor magnus, gracilis and sartorius than those with NGT (all P < 0.05). In sex-specific analyses, females have higher IMAT in adductor magnus than males (P < 0.001). Males with IGR had higher fat fraction of semitendinosus and sartorius than those with NGT (P = 0.020, P = 0.014, respectively). Logistic regression analyses revealed that IMAT content in semitendinosus was the independent factor of IGR in individuals with obesity after adjustment for age, gender, triglycerides, creatinine and albumin (odds ratio: 1.13, 95% CI: 1.02-1.26, P = 0.024). Increased adipose tissue accumulation in thigh muscles was associated with glucose dysregulation in patients with obesity. IMAT content in semitendinosus may serve as a possible risk factor for impaired glucose metabolism.

Altered expression of long noncoding RNA MEG3 in the offspring of gestational diabetes mellitus induces impaired glucose tolerance in adulthood.

Gestational diabetes mellitus (GDM) affects a significant number of women worldwide and has been associated with lifelong health consequences for their offspring, including increased susceptibility to obesity, insulin resistance, and type II diabetes. Recent studies have suggested that aberrant expression of the long non-coding RNA Meg3 in the liver may contribute to impaired glucose metabolism in individuals. In this study, we aimed to investigate whether intrauterine exposure to hyperglycemia affects glucose intolerance in puberty by mediating the overexpression of LncMeg3 in the liver. To test our hypothesis, we established an animal model of intrauterine hyperglycemia to mimic GDM. The progeny was observed for phenotypic changes, and intraperitoneal glucose tolerance tests, insulin tolerance tests, and pyruvate tolerance tests were conducted to assess glucose and insulin tolerance. We also measured LncMeg3 expression in the liver using real-time quantitative PCR and examined differential methylation areas (DMRs) in the Meg3 gene using pyrophosphoric sequencing. To investigate the role of LncMeg3 in glucose tolerance, we conducted Meg3 intervention by vein tail and analyzed the changes in the phenotype and transcriptome of the progeny using bioinformatics analysis. We found that intrauterine exposure to hyperglycemia led to impaired glucose and insulin tolerance in the progeny, with a tendency toward increased fasting blood glucose in fat offspring at 16weeks (P = 0.0004). LncMeg3 expression was significantly upregulated (P = 0.0061), DNMT3B expression downregulated (P = 0.0226), and DNMT3A (P = 0.0026), TET2 (P = 0.0180) expression upregulated in the liver. Pyrophosphoric sequencing showed hypomethylation in Meg3-DMRs (P = 0.0005). Meg3 intervention by vein tail led to a decrease in the percentage of obese and emaciated offspring (emaciation: 44% vs. 23%; obesity: 25% vs. 15%) and attenuated glucose intolerance. Bioinformatics analysis revealed significant differences in the transcriptome of the progeny, particularly in circadian rhythm and PPAR signaling pathways. In conclusion, our study suggests that hypomethylation of Meg3-DMRs increases the expression of the imprinted gene Meg3 in the liver of males, which is associated with impaired glucose tolerance in GDM-F1. MEG3 interference may attenuate glucose intolerance, which may be related to transcriptional changes. Our findings provide new insights into the mechanisms underlying the long-term effects of intrauterine hyperglycemia on progeny health and highlight the potential of Meg3 as an intervention target for glucose intolerance.

Favorable Effect of Pemafibrate on Insulin Resistance and β-Cell Function in Subjects with Type 2 Diabetes and Hypertriglyceridemia: A Subanalysis of the PARM-T2D Study.

Pemafibrate, a novel selective peroxisome proliferator-activated receptor modulator, has beneficial effects on lipid metabolism. However, its effects on glucose metabolism in individuals with type 2 diabetes (T2DM) remain to be fully clarified. This was a subanalysis of the PARM-T2D study, a multicenter prospective observational study on the use of pemafibrate versus conventional therapy for 52 weeks in subjects with T2DM complicated with hypertriglyceridemia. The subanalysis included participants who did not change their treatment for diabetes and did not receive insulin or insulin secretagogues during the study period. Changes in glucose metabolism markers, including homeostatic model assessment (HOMA2) scores and disposition index, were assessed. A total of 279 participants (141 in the pemafibrate group; 138 in the control group) met the criteria for the subanalysis. There were no significant changes in HbA1c during the 52-week study period in both groups. However, the pemafibrate group showed significant improvements versus the control group for insulin resistance assessed by HOMA2-R (-0.15 versus 0.08; estimated treatment difference -0.23 (95% confidence interval -0.44, -0.02); p = 0.03) and maintenance of β-cell function assessed by disposition index (0.015 versus -0.023; estimated treatment difference 0.037 (95% confidence interval 0.005, 0.069); p = 0.02). Correlation analyses showed that improvements in HOMA2-R and disposition index were significantly associated with improvements in lipid abnormalities and γ-glutamyl transpeptidase. In conclusion, pemafibrate reduced insulin resistance and maintained β-cell function in subjects with T2DM and hypertriglyceridemia, presumably by improving lipid profiles and lipid-related hepatocyte stress.

Longitudinal Associations of Dietary Sugars and Glycaemic Index with Indices of Glucose Metabolism and Body Fatness during 3-Year Weight Loss Maintenance: A PREVIEW Sub-Study

Background: Dietary sugars are often linked to the development of overweight and type 2 diabetes (T2D) but inconsistencies remain. Objective: We investigated associations of added, free, and total sugars, and glycaemic index (GI) with indices of glucose metabolism (IGM) and indices of body fatness (IBF) during a 3-year weight loss maintenance intervention. Design: The PREVIEW (PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World) study was a randomised controlled trial designed to test the effects of four diet and physical activity interventions, after an 8-week weight-loss period, on the incidence of T2D. This secondary observational analysis included pooled data assessed at baseline (8), 26, 52, 104 and 156 weeks from 514 participants with overweight/obesity (age 25–70 year; BMI ≥ 25 kg⋅m−2) and with/without prediabetes in centres that provided data on added sugars (Sydney and Helsinki) or free sugars (Nottingham). Linear mixed models with repeated measures were applied for IBF (total body fat, BMI, waist circumference) and for IGM (fasting insulin, HbA1c, fasting glucose, C-peptide). Model A was adjusted for age and intervention centre and Model B additionally adjusted for energy, protein, fibre, and saturated fat. Results: Total sugars were inversely associated with fasting insulin and C-peptide in all centres, and free sugars were inversely associated with fasting glucose and HbA1c (Model B: all p &lt; 0.05). Positive associations were observed between GI and IGM (Model B: fasting insulin, HbA1c, and C-peptide: (all p &lt; 0.01), but not for added sugars. Added sugar was positively associated with body fat percentage and BMI, and GI was associated with waist circumference (Model B: all p &lt; 0.01), while free sugars showed no associations (Model B: p &gt; 0.05). Conclusions: Our findings suggest that added sugars and GI were independently associated with 3-y weight regain, but only GI was associated with 3-y changes in glucose metabolism in individuals at high risk of T2D.

Gut microbiota-mediated associations of green tea and catechin intakes with glucose metabolism in individuals without type 2 diabetes mellitus: a four-season observational study with mediation analysis

This four-season observational study aimed to examine the mediating role of the gut microbiota in the associations between green tea and catechin intakes and glucose metabolism in individuals without type 2 diabetes mellitus (T2DM). In each of the 4 seasons, 85 individuals without T2DM (56 male [65.9%]; mean [standard deviation] age: 43.3 [9.4] years) provided blood samples, stool samples, 3-day weighed dietary records, and green tea samples. Catechin intake was estimated by analyzing the tea samples. Linear mixed-effects model analysis showed that green tea intake was negatively associated with fasting blood glucose and insulin levels, even after considering the seasonal variations. Of the gut microbial species associated with green tea intake, the mediation analysis revealed that Phocaeicola vulgatus mediated the association between green tea intake and fasting blood glucose levels. These findings indicate that green tea can improve glucose metabolism by decreasing the abundance of P. vulgatus that is associated with elevated blood glucose levels in individuals without T2DM.

Non-Alcoholic Fatty Liver Disease (NAFLD) Is an Independent Risk Factor for Developing New-Onset Diabetes After Acute Pancreatitis: A Multicenter Retrospective Cohort Study in Chinese Population.

BackgroundNumerous studies validated frequent glucose dysfunction in patients with acute pancreatitis (AP). However, the prevalence of new-onset diabetes in individuals after a first episode of AP varies widely among previous studies. This study aims to determine the incidence of post-acute pancreatitis diabetes mellitus (PPDM-A) in Chinese people and further identify potential risk factors that influence diabetes development in patients with AP.MethodsThis was a multi-center retrospective cohort study including 6009 inpatients with a first attack of AP. A total of 1804 patients with AP without known endocrine pancreatic disorders or other pancreatic exocrine diseases were eligible for analysis. Data was collected from medical records by hospital information system and telephone follow-ups after discharge. The multiple logistic regression analysis was established to evaluate the potential influencing factors of PPDM-A.ResultsThe prevalence of newly diagnosed diabetes after a first episode of AP in China was 6.2%. Data showed that patients who developed PPDM-A were more likely to be younger (X2 = 6.329, P = 0.012), experienced longer hospital stays (X2 = 6.949, P = 0.008) and had a higher frequency of overweight or obesity (X2 = 11.559, P = 0.003) compared to those with normal glycemia. The frequency of stress hyperglycemia on admission (X2 = 53.815, P < 0.001), hyperlipidemia (X2 = 33.594, P < 0.001) and non-alcoholic fatty liver disease (NAFLD) (X2 = 36.335, P < 0.001) were significantly higher among individuals with PPDM-A compared with control group. Also, patients with PPDM-A were more likely to be hyperlipidemic AP (X2 = 16.304, P = 0.001) and show a higher degree of severity (X2 = 7.834, P = 0.020) and recurrence rate (X2 = 26.908, P < 0.001) of AP compared to those without diabetes. In addition, multiple logistic regression analysis indicated that stress hyperglycemia, hyperlipidemia, NAFLD and repeated attacks of AP were the independent influence factors for developing PPDM-A.ConclusionOur study first demonstrated the prevalence of secondary diabetes in Chinese patients after AP. The disorder of glucose metabolism in individuals with AP should be regularly evaluated in clinical practice. Further studies are needed to verify the relationship between liver and pancreas in keeping glucose homeostasis under AP condition.

Dietary Fibre Intake in Type 2 and New-Onset Prediabetes/Diabetes after Acute Pancreatitis: A Nested Cross-Sectional Study.

The association between intake of dietary fibre and glucose metabolism has been extensively investigated in numerous metabolic disorders. However, little is known about this association in individuals after an attack of acute pancreatitis (AP). The aim was to investigate the associations between intake of dietary fibre and markers of glucose metabolism in individuals with new-onset prediabetes or diabetes after acute pancreatitis (NODAP), pre-exiting type 2 prediabetes or diabetes, and normoglycaemia after acute pancreatitis. This cross-sectional study was nested within the parent prospective longitudinal cohort study. The studied markers of glucose metabolism were fasting plasma glucose and glycated haemoglobin. Habitual intake of dietary fibre was determined using the EPIC-Norfolk food frequency questionnaire. Multivariable linear regression analyses were conducted. The study included a total of 108 individuals after AP. In the NODAP group, increased intakes of total fibre (β = −0.154, p = 0.006), insoluble fibre (β = −0.133, p = 0.01), and soluble fibre (β = −0.13, p = 0.02) were significantly associated with a reduction in fasting plasma glucose. Increased intakes of vegetables (β = −0.069, p = 0.004) and nuts (β = −0.039, p = 0.038) were significantly associated with a reduction in fasting plasma glucose. Increased intake of nuts (β = −0.054, p = 0.001) was also significantly associated with a reduction in glycated haemoglobin. None of the above associations were significant in the other study groups. Habitual intake of dietary fibre was inversely associated with fasting plasma glucose in individuals with NODAP. Individuals after an attack of AP may benefit from increasing their intake of dietary fibre (specifically, vegetables and nuts) with a view to preventing NODAP.

Association between Habitual Dietary Iron Intake and Glucose Metabolism in Individuals after Acute Pancreatitis.

Dietary intake of iron is known to be associated with impaired glucose metabolism. However, its involvement in derangements of glucose metabolism after acute pancreatitis (AP) is not completely understood. The aim was to investigate the association between dietary iron intake and markers of glucose metabolism in individuals after an attack of AP. Fasting blood samples were collected to analyse markers of glucose metabolism (fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c)). The EPIC-Norfolk food frequency questionnaire was used to determine the habitual intake of dietary iron (total, haem, and non-haem). Multivariable linear regression analyses were conducted and six statistical models were built to adjust for covariates. A total of 109 individuals after AP were studied in a cross-sectional fashion. Total iron (β (95% confidence interval) = −0.19 (−0.35, −0.05); p = 0.01 in the most adjusted model) and non-haem iron (β (95% confidence interval) = −0.19 (−0.33, −0.04); p = 0.03 in the most adjusted model) were significantly associated with FPG, consistently in all adjusted model. Total iron and non-haem iron did not have consistent significant associations with HbA1c. Dietary haem iron intake was not associated with either FPG or HbA1c. Habitual intake of dietary iron is inversely associated with FPG in individuals after an attack of AP and may be involved in the pathogenesis of new-onset diabetes after pancreatitis. Prospective longitudinal studies are now warranted to unveil the specific mechanism underlying the involvement of dietary iron.

Adding Resistance Training To Endurance Training Improves Glucose Metabolism In Individuals With Metabolic Syndrome

Elevated fasting blood glucose is one of the five components of metabolic syndrome (MetS) which is a cluster of anthropometric, metabolic and cardiovascular derangements. Insulin resistance (IR) has been identified as an important risk factor to develop diabetes (i.e, T2D) and MetS. Both, aerobic (AT) and resistance training (RT) prevent the development of T2D although it is unclear which is most effective. It has been suggested that mechanisms to improve IR are different between AT and RT. Thus, we hypothesized that the combination of both modes of training could provide additive effects to treat IR. PURPOSE: To determine whether the addition of resistance training (RT) to high-intensity interval training (HIIT) was able to improve glucose metabolism in patients with metabolic syndrome (MetS). METHODS: One hundred MetS patients (age, 56±8 years; weight, 92±17 kg; and Mets factors, 3.8±0.8 components) were randomized to undergo one of the following 16-wk program: (a) 4 x 4-min high-intensity interval training at 90% of HRMAX plus 3 sets of 8-12 rep at 60-85% 1RM of 3 legs free-weight exercises (HIIT+RT group; n=35), (b) 5 x 4-min high-intensity interval training at 90% of HRMAX (HIIT group; n=43) or (c) no exercise control group (CONT group; n=22). We measured the evolution of all five MetS components (i.e. Z-score), CRF (i.e. VO2max), legs strength and power (i.e. leg press 1RM and countermovement jump (CMJ)) and fasting glucose (FG) and insulin (FI) to calculate HOMA-IR before and after intervention. Pre-intervention FG was similar among groups (110±23; 115±21; 121±30, mg·dL-1 for HIIT, HIIT+RT and CON, respectively). RESULTS: After 16 weeks of training, HIIT+RT improved CMJ and 1RM leg press above HIIT and CON (P<0.010). After 16 weeks of training FG (4%; p=0.046) and HOMA-IR (18%; p=0.032), decreased only in HIIT+RT. However, both training groups improved similarly their VO2max (HIIT+RT, 7%, p=0.001; HIIT, 11%, p<0.001) and Z-score (HIIT+RT, 43%, P=0.022; HIIT, 63%, P=0.004). CONCLUSION: Our findings suggest that in initially sedentary individuals with MetS, RT combined with HIIT further improves the insulin-sensitizing effects of exercise reducing glucose concentrations.

Panorama of mediators in postpancreatitis diabetes mellitus.

To provide an overview of mediators involved in the pathogenesis of postacute pancreatitis diabetes mellitus. The 'holistic prevention of pancreatitis' framework has brought to the fore the sequelae of not only end-stage chronic pancreatitis and extensive pancreatic necrosis but also mild acute pancreatitis. Insights from the DORADO project have provided a wealth of information on the signalling molecules that do and do not affect glucose metabolism in individuals after mild acute pancreatitis and have challenged conventional views of the pathogenesis of postpancreatitis diabetes mellitus. Growing evidence compels a reconsideration of the dogma that mechanical β-cell destruction (and the resulting insulin deficiency) is the only underlying mechanism of postpancreatitis diabetes mellitus. Chronic low-grade inflammation, β-cell compensation, lipolysis, altered secretion of gut hormones, and changes in iron metabolism characterize postacute pancreatitis diabetes mellitus. Some of these are druggable targets that offer novel opportunities to reduce the burden of pancreatitis through tertiary prevention.

&amp;lt;I&amp;gt;ACTN3&amp;lt;/I&amp;gt; R577X Polymorphism Impacts Glucose Consumption at Simulated High Altitude

Introduction: High altitude acclimatization is a process that involve several physiological adjustments, which may increase glucose metabolism because of acute hypoxic exposure. Native highlanders like Tibetans show an increased anaerobic glucose metabolism and a higher proportion of type I muscle fiber than lowlanders. Actin filaments are anchored to the Z line of the sarcomere by a protein called alpha-actinin that exist in two isoforms in the muscle (ACTN2 and ACTN3), however ACTN3 is present only in type II fibers, especially in type IIx. Homozygous individuals for a 577X polymorphism in the ACTN3 gene do not express ACTN3 and seem to be more type I muscle fiber than homozygous individuals 577R. The aim of this study was to compare the glucose consumption response of individuals with different ACTN3 genotypes at simulated 4,500 m altitude. Materials & Methods: Twenty-three volunteers spent four hours exposed to a simulated altitude of 4,500 m inside a normobaric hypoxia chamber. Lactate and glucose concentrations, SpO2 and heart rate were analyzed immediately before entering the chamber and at each hour during the exposure. Results: Glucose after four hours of exposure to hypoxia was different between groups, with RX (68.1 ± 11.7 mg/dl) and RR (71.7 ± 14.4 mg/dl) showing a decreased blood glucose compared to XX (88.7 ± 14.1 mg/dl), indicating an increased dependence on glucose metabolism in individuals with at least one R allele after exposure at 4,500 m simulated altitude. Conclusions: We concluded that individuals with at least one R allele of the ACTN3 R577X gene polymorphism consume more glucose than the ones with XX genotype.

Effect of Short-Term Increase in Meal Frequency on Glucose Metabolism in Individuals with Normal Glucose Tolerance or Impaired Fasting Glucose: A Randomized Crossover Clinical Trial.

Effects of meal frequency on blood glucose levels and glucose metabolism were evaluated over 3 days in adult males with normal glucose tolerance (NGT, n = 9) or impaired fasting glucose (IFG, n = 9) in a randomized, crossover comparison study. Subjects were provided with an isocaloric diet 3 times daily (3M) or 9 times daily (9M). Blood glucose was monitored on Day 3 using a continuous glucose monitoring system, and subjects underwent a 75-g oral glucose tolerance test (OGTT) on Day 4. Daytime maximum blood glucose, glucose range, duration of glucose ≥180 mg/dL, and nighttime maximum glucose were significantly lower in the NGT/9M condition than in the NGT/3M condition. Similar findings were observed in the IFG subjects, with a lower daytime and nighttime maximum glucose and glucose range, and a significantly higher daytime minimum glucose in the 9M condition than in the 3M condition. The OGTT results did not differ significantly between NGT/3M and NGT/9M conditions. In contrast, the incremental area under the curve tended to be lower and the maximum plasma glucose concentration was significantly lower in the IFG/9M condition than in the IFG/3M condition. In IFG subjects, the 9M condition significantly improved glucose metabolism compared with the 3M condition. Higher meal frequency may increase glucagon-like peptide 1 secretion and improve insulin secretion.

NAFLD and Diabetes: Two Sides of the Same Coin? Rationale for Gene-Based Personalized NAFLD Treatment.

The prevalence of non-alcoholic fatty liver disease (NAFLD) has been increasing rapidly and at the forefront of worldwide concern. Characterized by excessive fat accumulation in the liver, NAFLD regularly coexists with metabolic disorders, including type 2 diabetes, obesity, and cardiovascular disease. It has been well established that the presence of NAFLD increases the incidence of type 2 diabetes, while diabetes aggravates NAFLD to more severe forms of steatohepatitis, cirrhosis, and hepatocellular carcinoma. However, recent progress on the genotype/phenotype relationships in NAFLD patients indicates the development of NAFLD with a relative conservation of glucose metabolism in individuals with specific gene variants, such as the patatin-like phospholipase domain-containing 3 (PNPLA3) and transmembrane 6 superfamily member 2 protein (TM6SF2) variants. This review will focus on the clinical and pathophysiological connections between NAFLD and type 2 diabetes and will also discuss a disproportionate progression of NAFLD and diabetes, and the different responses to lifestyle and drug intervention in NAFLD patients with specific gene variants that may give insight into personalized treatment for NAFLD.