Effect of a nutritional liquid supplement designed for the patient with diabetes mellitus (Glucerna SR) on the postprandial glucose state, insulin secretion and insulin sensitivity in healthy subjects

Abstract An increased prevalence of impaired glucose homeostasis (IGH) and diabetes mellitus is reported in monosomy X, or Turner syndrome (TS). To determine whether IGH is an intrinsic feature of this syndrome, independent of obesity or hypogonadism, we compared results of a standard oral glucose challenge in age- and body mass index-matched women with TS and with karyotypically normal premature ovarian failure (POF). Fasting glucose levels were normal in both groups, but glucose values after oral glucose challenge were higher in TS [2-h glucose, 135 ± 36 mg/dl (7.5 ± 2.0 mmol/liter) in TS and 97 ± 18 mg/dl (5.4 ± 1.0 mmol/liter) in POF; P < 0.0001]. Glucose-stimulated insulin secretion was lower in TS; e.g. the initial insulin response (ΔI/ΔG30) was decreased by 60% compared with POF (P < 0.0001). We also compared responses to a standard iv glucose tolerance test in women with TS and in age- and body mass index-matched normal women and found that the insulin area under the curve was 50% lower in women with TS (P = 0.003). Insulin sensitivity measured by the quantitative insulin sensitivity check index was higher in women with TS compared with both control groups. Thus, IGH is not secondary to obesity or hypogonadism in TS, but it is a distinct entity characterized by decreased insulin secretion, suggesting that haploinsufficiency for X-chromosome gene(s) impairs β-cell function and predisposes to diabetes mellitus in TS.

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Plasma FGF-21 and Sclerostin Levels, Glycemia, Adiposity and Insulin Sensitivity in Normoglycemic Black and White Adults

Journal of the Endocrine Society ◽

10.1210/jendso/bvab183 ◽

2021 ◽

Author(s):

Nkiru Umekwe ◽

Ibiye Owei ◽

Frankie Stentz ◽

Sam Dagogo-Jack

Keyword(s):

Type 2 Diabetes ◽

Body Mass Index ◽

Insulin Secretion ◽

Insulin Sensitivity ◽

Healthy Subjects ◽

Fibroblast Growth ◽

Black And White ◽

Fasting Plasma ◽

White Adults

Abstract Increased circulating fibroblast growth factor (FGF)-21 and sclerostin levels have been reported in patients with type 2 diabetes (T2D). We assessed the association of FGF-21 and sclerostin with adiposity, glycemia and glucoregulatory measures in healthy subjects. We studied 20 normoglycemic Black and White offspring of parents with T2D. Assessments included OGTT, insulin sensitivity (Si-clamp), insulin secretion (HOMA-B), and body fat (DXA). Fasting plasma FGF-21 and sclerostin levels were measured with ELISAs. The participants' mean (+SD) age was 50.4 ± 5.97 yr; BMI 32.5 ± 5.86 kg/m2; fasting plasma glucose (FPG) 96.1 ± 5.21 mg/dl, and 2-hr post-load glucose (2hPG) 116 ± 5.45 mg/dl. FGF-21 levels were similar in Blacks vs. Whites (0.36 ± 0.15 ng/ml vs. 0.39 ± 0.25 ng/ml), men vs. women (0.45 ± 0.14 vs. 0.44 ± 0.07ng/ml), correlated positively with body mass index (BMI) (r=0.23, P=0.05) and waist circumference (r=0.27, P=0.04), and inversely with FPG (r= -0.26, P=0.05). Sclerostin levels also were similar in Blacks (33.5 ± 17.1 pmol/l) vs. Whites (34.2 ± 6.41 pmol/l), men vs. women (35.3 ± 9.01 pmol/l vs. 32.3 ± 15.8 pmol/l), and correlated inversely with FPG (r= - 0.11-0.44) but not adiposity measures. The correlation coefficient between Si-clamp values and FGF-21 levels was -0.31 (P=0.09) compared with 0.04 (P=0.89) for sclerostin levels. FGF-21 and sclerostin levels were not correlated with each other or HOMA-B. Among healthy Black and White subjects, plasma FGF-21 and sclerostin showed differential associations with adiposity but concordant association with FPG levels.

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Glucose tolerance and insulin responsiveness in Gitelman syndrome patients

Endocrine Connections ◽

10.1530/ec-17-0014 ◽

2017 ◽

Vol 6 (4) ◽

pp. 243-252 ◽

Cited By ~ 9

Author(s):

Tao Yuan ◽

Lanping Jiang ◽

Chen Chen ◽

Xiaoyan Peng ◽

Min Nie ◽

...

Keyword(s):

Insulin Secretion ◽

Insulin Sensitivity ◽

Glucose Metabolism ◽

Healthy Subjects ◽

Potassium Level ◽

Serum Glucose ◽

Oral Glucose ◽

Oral Glucose Load ◽

Glucose Load

Objective Impaired glucose metabolism and insulin sensitivity have been reported in patients with Gitelman syndrome (GS), but insulin secretion and the related mechanisms are not well understood. Design and methods The serum glucose levels, insulin secretion and insulin sensitivity were evaluated in patients with GS (n = 28), patients with type 2 diabetes mellitus (DM) and healthy individuals (n = 20 in both groups) using an oral glucose tolerance test. Serum and urine sodium, potassium and creatinine levels were measured at 0, 30, 60, 120 and 180 min after an oral glucose load was administered. Results The areas under the serum glucose curves were higher in the GS patients than those in the healthy controls (17.4 ± 5.1 mmol·h/L vs 14.5 ± 2.8 mmol·h/L, P = 0.02) but lower than those in the DM patients (24.8 ± 5.3 mmol·h/L, P < 0.001). The areas under the serum insulin curves and the insulin secretion indexes in GS patients were higher than those in DM patients and lower than those in healthy subjects. The insulin secretion-sensitivity index of GS patients was between that of healthy subjects and DM patients, but the insulin sensitivity indices were not different among the three groups. After one hour of glucose administration, the serum potassium level significantly decreased from baseline, and the urinary potassium-to-creatinine ratio increased gradually and peaked at 2 h. Conclusions Glucose metabolism and insulin secretion were impaired in GS patients, but insulin sensitivity was comparable between GS patients and patients with type 2 DM. After administration of an oral glucose load, the plasma potassium level decreased in GS patients due to the increased excretion of potassium in the urine.

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