scholarly journals Kinetics of C-peptide During Mixed Meal Test and Its Value for Treatment Optimization in Monogenic Diabetes Patients

2021 ◽  
pp. 108938
Author(s):  
Ingrida Stankute ◽  
Rasa Verkauskiene ◽  
Rimante Dobrovolskiene ◽  
Evalda Danyte ◽  
Edita Jasinskiene ◽  
...  
Keyword(s):  
Monogenic Diabetes ◽  
Meal Test ◽  
Treatment Optimization ◽  
Mixed Meal ◽  
C Peptide ◽  
Mixed Meal Test ◽  
Kinetics Of ◽  
Diabetes Patients

scholarly journals Predictors of Postprandial Hypoglycemia After Gastric Bypass Surgery: a Retrospective Case-Control Study

2021 ◽  
Author(s):  
Elric Zweck ◽  
Matthias Hepprich ◽  
Marc Y. Donath
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Gastric Bypass Surgery ◽  
Glycosylated Hemoglobin ◽  
Relative Weight ◽  
Meal Test ◽  
Retrospective Case ◽  
Mixed Meal ◽  
Absolute Weight ◽  
Mixed Meal Test

Abstract Background Postprandial hypoglycemia after bariatric surgery is an exigent disorder, often impacting the quality of life. Distinguishing clinically relevant hypoglycemic episodes from symptoms of other origin can be challenging. Diagnosis is demanding and often requires an extensive testing such as prolonged glucose tolerance or mixed-meal test. Therefore, we investigated whether baseline parameters of patients after gastric bypass with suspected hypoglycemia can predict the diagnosis. Methods We analyzed data from 35 patients after gastric bypass with suspected postprandial hypoglycemia and performed a standardized mixed-meal test. Hypoglycemia was defined by the appearance of typical symptoms, low plasma glucose, and relief of symptoms following glucose administration. Parameters that differed in patients with and without hypoglycemia during MMT were identified and evaluated for predictive precision using receiver operating characteristic (ROC) areas under the curve (AUC). Results Out of 35 patients, 19 (54%) developed symptomatic hypoglycemia as a result of exaggerated insulin and C-peptide release in response to the mixed-meal. Hypoglycemic patients exhibited lower glycosylated hemoglobin A1c (HbA1c) and higher absolute and relative weight loss from pre-surgery to study date. HbA1c and absolute weight loss alone could achieve acceptable AUCs in ROC analyses (0.76 and 0.72, respectively) but a combined score of absolute weight loss divided by HbA1c (0.78) achieved the best AUC. Conclusions HbA1c and weight loss differed in patients with and without symptomatic hypoglycemia during mixed-meal test. These baseline parameters could be used for screening of postprandial hypoglycemia in patients after gastric bypass and may facilitate the selection of patients requiring further evaluation. Graphical abstract

Pancreatic and gut hormone responses to mixed meal test in post-chronic pancreatitis diabetes mellitus

2021 ◽  
pp. 101316
Author(s):  
Liang Qi ◽  
Qiong Wei ◽  
Muhan Ni ◽  
Dechen Liu ◽  
Jiantong Bao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Pancreatitis ◽  
Meal Test ◽  
Mixed Meal ◽  
Gut Hormone ◽  
Mixed Meal Test ◽  
Hormone Responses

scholarly journals Abnormal Non Esterified Fatty Acid Suppression After a Mixed Meal Test in Patients With Partial Lipodystrophy

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A1-A2
Author(s):  
Maria Cristina Foss de Freitas ◽  
Baris Akinci ◽  
Elif A Oral
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Fatty Acids ◽  
Adipose Tissue ◽  
Meal Test ◽  
Mixed Meal ◽  
Partial Lipodystrophy ◽  
Mixed Meal Test

Abstract Elevated levels of non-esterified fatty acids (NEFA) have been observed in individuals with several clinical scenarios of insulin resistance, such as in diabetes mellitus and lipodystrophy. Insulin is a well-known stimulator of de novo lipogenesis. Despite the reduction of adipose tissue mass, paradoxically elevated circulating NEFA concentrations have been observed in patients with different lipodystrophy syndromes. Aiming to understand the behavior of NEFA in lipodystrophy versus common Type 2 diabetes mellitus during feeding, we compared NEFA kinetics during a mixed meal test in patients with partial lipodystrophy (PL) and Type 2 diabetes mellitus (DM). We reviewed data from 17 PL patients (13F/4M, ages 12–64) matched by gender and BMI to 20 DM patients (13F/7M, ages 24–72). All patients were evaluated during fasting state and then underwent a mixed meal test (MMT). Blood samples were collected before (fasting) and at 30, 60, 90, 120, and 180 minutes post-meal to measure glucose, insulin, non-esterified free fatty acids (NEFA), and triglyceride levels. Adipose tissue insulin resistance (ADIPO-IR) and homeostatic model of insulin resistance (HOMA-IR) were calculated from the fasting measurements, and the area under the curve (AUC) and maximum percentage of change from baseline were calculated from the MMT data. Fasting insulin and triglyceride (Tg) levels were lower in the DM group compared to the PL group (Insulin: 24.4±13.7 vs. 68.0±67.2 pmol/L, p=0.003 and Tg: 168.0±107.7 vs. 1378.3±1927.3 mg/dL, p<0.001). HOMA-IR was significantly higher in the PL group compared to the DM group (6.0±2.1 vs. 3.3±1.5, p=0.005), as well as ADIPO-IR (297.0±241.1 vs. 115.3±80.1, p=0.03). NEFA, glucose and triglyceride AUC were significantly higher in the PL group compared to the DM group. Patients with PL had higher glucose and triglyceride levels throughout the MMT at all-time points. Interestingly, NEFA levels were similar in both groups at baseline, but the PL group suppressed NEFA less than DM group (54.9±13.3% vs. 69.2±11.1%, p=0.002) despite higher insulin levels. Additionally, we divided the PL group according to the presence of a pathogenic variant in the lamin A gene (n=8) versus those without mutations in this gene (n=9), but there were no notable differences among these subgroups with respect to NEFA levels at baseline or during the meal. These findings support the need to better understand and address the origins of abnormal NEFA kinetics and adipose tissue insulin resistance in PL patients.

scholarly journals Antidiabetic Effects of NRDT50, the Enzyme Composition for Regulating Sugar Metabolism, in Db/db Mice

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A317-A317
Author(s):  
Daham Kim ◽  
Cheol Ryong Ku ◽  
Jung Seung Kim ◽  
Jihwan Hwang ◽  
Yoon Hee Cho ◽  
...  
Keyword(s):  
Blood Glucose ◽  
The Body ◽  
Postprandial Blood Glucose ◽  
Standard Diet ◽  
Meal Test ◽  
Mixed Meal ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Mixed Meal Test ◽  
Antidiabetic Effects

Abstract Objective: The enzyme composition (NRDT50) which includes glucosyl transferase, fructosyl transferase, amylase, glucose oxidase, and catalase can regulate the absorption of glucose into the body by converting the carbohydrates in food to a form of sugar that is not absorbed in the stomach before being decomposed in the small intestine into glucose. The aim of this study was to evaluate the antidiabetic effects of repeated oral administration of NRDT50 in db/db mice. Methods: The 7-week-old db/db mice were divided into 3 groups; control, NRDT50 (300mg/kg/day), and voglibose (0.3mg/kg/day). Mice received a standard diet containing drugs for 1 month. Fasting and postprandial glucose level was measured every week. Mixed meal test, biochemical assays, and fecal microbiota analysis were performed. Results: There were no significant differences in body weight or food intake between the three groups. However, NRDT50 treatment led to a significant reduction in fasting and postprandial blood glucose levels compared to control after 3, 4 weeks. The blood glucose levels during the mixed meal test were significantly lower in NRDT50 group compared to control group. NRDT50 treatment reduced triglyceride level, tend to reduce LDL level, and increased relative Bacteroidetes-Firmicutes ratio. NRDT50 treatment did not demonstrate any negative side effects on biochemical and histopathological examination. Conclusion: NRDT50 is expected to be useful for people who are at risk of hyperglycemia or diabetes and thus need to regulate blood sugar with safe. It may also improve the gut microbiota profile by inducing the production of oligosaccharides in the alimentary tract.

scholarly journals Evaluation of a Mixed Meal Test for Diagnosis and Characterization of PancrEaTogEniC DiabeTes Secondary to Pancreatic Cancer and Chronic Pancreatitis

Pancreas ◽  
2018 ◽  
Vol 47 (10) ◽  
pp. 1239-1243 ◽  
Author(s):  
Phil A. Hart ◽  
Dana K. Andersen ◽  
Kieren J. Mather ◽  
Alicia C. Castonguay ◽  
Mandeep Bajaj ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Chronic Pancreatitis ◽  
Meal Test ◽  
Mixed Meal ◽  
Pancreatogenic Diabetes ◽  
Mixed Meal Test

scholarly journals Exenatide Treatment Causes Suppression of Serum Ghrelin Levels following Mixed Meal Test in Obese Diabetic Women

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Figen Topyildiz ◽  
Sinem Kiyici ◽  
Zulfiye Gul ◽  
Deniz Sigirli ◽  
Metin Guclu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Area Under The Curve ◽  
Meal Test ◽  
Mixed Meal ◽  
Female Patients ◽  
Mixed Meal Test ◽  
Serum Ghrelin

Aim. To investigate the effect of exenatide treatment on serum ghrelin levels in obese female patients with type 2 diabetes mellitus.Methods. Fourteen female patients with type 2 diabetes mellitus being treated with metformin and exenatide were enrolled. A mixed meal test was applied to the patients while continuing with their daily medications. Blood samples were taken before and at 60, 120, and 180 minutes following mixed meal test to measure serum total ghrelin, glucose, and insulin levels. The following week, exenatide treatment of the patients was paused for 24 hours and the same experimental procedures were repeated.Results. Serum ghrelin levels were suppressed significantly at 180 minutes with exenatide treatment compared with baseline (294.4±57.5versus234.5±59.4 pg/mL) (p<0.001). Serum ghrelin levels at 180 minutes were statistically different when percentage change in serum ghrelin levels after mixed meal tests with and without exenatide usage were compared (p=0.001). Estimated total area under the curve values for serum ghrelin concentrations was also significantly lower with exenatide compared with omitted treatment (p=0.035).Conclusion. These results suggest that the effect of exenatide on weight loss may be related with the suppression of serum ghrelin levels, which is an orexigenic peptide.

Hypoglycemia after Roux-En-Y gastric bypass: detection rates of continuous glucose monitoring (CGM) versus mixed meal test

2015 ◽  
Vol 11 (3) ◽  
pp. 564-569 ◽  
Author(s):  
Ronald Kefurt ◽  
Felix B. Langer ◽  
Karin Schindler ◽  
Soheila Shakeri-Leidenmühler ◽  
Bernhard Ludvik ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Meal Test ◽  
Mixed Meal ◽  
Detection Rates ◽  
Mixed Meal Test

Weight classification does not influence the short-term endocrine or metabolic effects of high-fructose corn syrup-sweetened beverages

2014 ◽  
Vol 39 (5) ◽  
pp. 544-552 ◽  
Author(s):  
Timothy D. Heden ◽  
Ying Liu ◽  
Monica L. Kearney ◽  
Jill A. Kanaley
Keyword(s):  
Insulin Secretion ◽  
Insulin Sensitivity ◽  
Metabolic Effects ◽  
Meal Test ◽  
Short Term ◽  
Mixed Meal ◽  
Sweetened Beverages ◽  
High Fructose ◽  
Mixed Meal Test ◽  
Weight Classification

Obesity and high-fructose corn syrup (HFCS)-sweetened beverages are associated with an increased risk of chronic disease, but it is not clear whether obese (Ob) individuals are more susceptible to the detrimental effects of HFCS-sweetened beverages. The purpose of this study was to examine the endocrine and metabolic effects of consuming HFCS-sweetened beverages, and whether weight classification (normal weight (NW) vs. Ob) influences these effects. Ten NW and 10 Ob men and women who habitually consumed ≤355 mL per day of sugar-sweetened beverages were included in this study. Initially, the participants underwent a 4-h mixed-meal test after a 12-h overnight fast to assess insulin sensitivity, pancreatic and gut endocrine responses, insulin secretion and clearance, and glucose, triacylglycerol, and cholesterol responses. Next, the participants consumed their normal diet ad libitum, with 1065 mL per day (117 g·day–1) of HFCS-sweetened beverages added for 2 weeks. After the intervention, the participants repeated the mixed-meal test. HFCS-sweetened beverages did not significantly alter body weight, insulin sensitivity, insulin secretion or clearance, or endocrine, glucose, lipid, or cholesterol responses in either NW or Ob individuals. Regardless of previous diet, Ob individuals, compared with NW individuals, had ∼28% lower physical activity levels, 6%–9% lower insulin sensitivity, 12%–16% lower fasting high-density-lipoprotein cholesterol concentrations, 84%–144% greater postprandial triacylglycerol concentrations, and 46%–79% greater postprandial insulin concentrations. Greater insulin responses were associated with reduced insulin clearance, and there were no differences in insulin secretion. These findings suggest that weight classification does not influence the short-term endocrine and metabolic effects of HFCS-sweetened beverages.

Sign in / Sign up

Export Citation Format

Share Document