scholarly journals Effects of carbohydrate quality and amount on plasma lactate: results from the OmniCarb trial

2020 ◽  
Vol 8 (1) ◽  
pp. e001457
Author(s):  
Jiun-Ruey Hu ◽  
Yingfei Wu ◽  
Frank M Sacks ◽  
Lawrence J Appel ◽  
Edgar R Miller III ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
Plasma Lactate ◽  
Obese Adults ◽  
High Carbohydrate ◽  
Term Change ◽  
Carbohydrate Quality ◽  
Low Carbohydrate ◽  
Registration Number ◽  
Lactate Levels ◽  
Design And Methods

IntroductionPlasma lactate is a marker of non-oxidative glucose metabolism associated with progression to diabetes. We examined the effect of carbohydrate quality (glycemic index (GI)) and amount (%kcal) on plasma lactate. We hypothesized that low GI (≤45 (g)) versus high (≥65 (G)) and low %kcal from carbohydrate (40% kcal (c)) versus high (58% kcal (C)) each would reduce lactate levels.Research design and methodsWe measured lactate in OmniCarb, a randomized, cross-over trial of four diets in overweight/obese adults without diabetes or cardiovascular disease (N=163). The four diets were high carbohydrate+high GI (CG, reference), high carbohydrate+low GI (Cg), low carbohydrate+high GI (cG), and low carbohydrate+low GI (cg). Participants (N=163) consumed each of the four diets over a 5-week period, separated by 2-week washout periods. Plasma lactate levels were measured at baseline, during which the participants consumed their own diets, and after each 5-week period.ResultsBaseline plasma lactate was 1.2 mmol/L. In the setting of high carbohydrate amount, reducing GI lowered plasma lactate non-significantly by 0.08 mmol/L (Cg vs CG: 95% CI −0.16 to 0.00; p=0.06). In the setting of high GI, reducing carbohydrate amount lowered plasma lactate by 0.10 mmol/L (cG vs CG: 95% CI −0.19 to −0.02; p=0.02). The combined effect of reducing GI and carbohydrate proportion in the diet (cg vs CG) was similar (cg vs CG: −0.08; 95% CI −0.16 to 0.00; p=0.04). All four diets reduced plasma lactate compared with baseline.ConclusionsCompared with a diet with high GI and high carbohydrate amount, diets with low GI and/or low carbohydrate amount reduced plasma lactate. Whether this change in lactate leads to long-term change in glucose metabolism needs to be examined.Trial registration numberNCT00608049.

scholarly journals Patterns of postmeal insulin secretion in individuals with sulfonylurea-treated KCNJ11 neonatal diabetes show predominance of non-KATP-channel pathways

2019 ◽  
Vol 7 (1) ◽  
pp. e000721
Author(s):  
Pamela Bowman ◽  
Timothy J McDonald ◽  
Bridget A Knight ◽  
Sarah E Flanagan ◽  
Maria Leveridge ◽  
...  
Keyword(s):  
Insulin Secretion ◽  
Area Under The Curve ◽  
Neonatal Diabetes ◽  
Permanent Neonatal Diabetes ◽  
Glucose Levels ◽  
High Carbohydrate ◽  
Versus Protein ◽  
Registration Number ◽  
Low Glucose ◽  
Design And Methods

ObjectiveInsulin secretion in sulfonylurea-treated KCNJ11 permanent neonatal diabetes mellitus (PNDM) is thought to be mediated predominantly through amplifying non-KATP-channel pathways such as incretins. Affected individuals report symptoms of postprandial hypoglycemia after eating protein/fat-rich foods. We aimed to assess the physiological response to carbohydrate and protein/fat in people with sulfonylurea-treated KCNJ11 PNDM.Research design and methods5 adults with sulfonylurea-treated KCNJ11 PNDM and five age, sex and body mass index-matched controls without diabetes had a high-carbohydrate and high-protein/fat meal on two separate mornings. Insulin(i) and glucose(g) were measured at baseline then regularly over 4 hours after the meal. Total area under the curve (tAUC) for insulin and glucose was calculated over 4 hours and compared between meals in controls and KCNJ11 cases.ResultsIn controls, glucose values after carbohydrate and protein/fat were similar (median glucose tAUC0-4h21.4 vs 19.7 mmol/L, p=0.08). In KCNJ11 cases glucose levels were higher after carbohydrate than after protein/fat (median glucose tAUC0-4h58.1 vs 31.3 mmol/L, p=0.04). These different glycemic responses reflected different patterns of insulin secretion: in controls, insulin secretion was greatly increased after carbohydrate versus protein/fat (median insulin tAUC0-4h727 vs 335 pmol/L, p=0.04), but in KCNJ11 cases insulin secretion was similar after carbohydrate and protein/fat (median insulin tAUC0-4h327 vs 378 pmol/L, p=0.50).ConclusionsIndividuals with sulfonylurea-treated KCNJ11 PNDM produce similar levels of insulin in response to both carbohydrate and protein/fat meals despite carbohydrate resulting in much higher glucose levels and protein/fat resulting in relatively low glucose levels. This suggests in an inability to modulate insulin secretion in response to glucose levels, consistent with a dependence on non-KATP pathways for insulin secretion.Trial registration numberNCT02921906.

scholarly journals A randomised-controlled trial of the effects of very low-carbohydrate and high-carbohydrate diets on cognitive performance in patients with type 2 diabetes

2016 ◽  
Vol 116 (10) ◽  
pp. 1745-1753 ◽  
Author(s):  
Jeannie Tay ◽  
Ian T. Zajac ◽  
Campbell H. Thompson ◽  
Natalie D. Luscombe-Marsh ◽  
Vanessa Danthiir ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Cognitive Function ◽  
Cognitive Performance ◽  
Perceptual Speed ◽  
Low Fat ◽  
Obese Adults ◽  
High Carbohydrate ◽  
Low Carbohydrate

AbstractThis study compared the longer-term effects of a very low-carbohydrate, high-fat diet with a high-carbohydrate, low-fat diet on cognitive performance in individuals with type 2 diabetes (T2D). In total, 115 obese adults with T2D (sixty-six males, BMI: 34·6 (sd 4·3) kg/m2, age: 58 (sd 7) years, HbA1c: 7·3 (sd 1·1) %, diabetes duration: 8 (sd 6) years) were randomised to consume either an energy-restricted, very low-carbohydrate, low-saturated-fat (LC) diet or an energy-matched high unrefined carbohydrate, low-fat (HC) diet with supervised aerobic/resistance exercise (60 min, 3 d/week) for 52 weeks. Body weight, HbA1c and cognitive performance assessing perceptual speed, reasoning speed, reasoning ability, working memory, verbal fluency, processing speed, short-term memory, inhibition and memory scanning speed were assessed before and after intervention. No differences in the changes in cognitive test performance scores between the diet groups were observed for any of the cognitive function outcomes assessed (P≥0·24 time×diet). Percentage reduction in body weight correlated with improvements with perceptual speed performance. In obese adults with T2D, both LC and HC weight-loss diets combined with exercise training had similar effects on cognitive performance. This suggests that an LC diet integrated within a lifestyle modification programme can be used as a strategy for weight and diabetes management without the concern of negatively affecting cognitive function.

723-P: Effect of Low-Carbohydrate High-Fat vs. High-Carbohydrate Low-Fat Diet on HbA1c Control in Chinese Patients with Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 723-P
Author(s):  
LINGWANG AN ◽  
DANDAN WANG ◽  
XIAORONG SHI ◽  
CHENHUI LIU ◽  
KUEICHUN YEH ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chinese Patients ◽  
High Fat ◽  
Low Fat ◽  
High Carbohydrate ◽  
Low Fat Diet ◽  
Low Carbohydrate ◽  
Hba1c Control

scholarly journals Modifying Carbohydrate Supply to Fruit during Development Changes the Composition and Flavour of Actinidia chinensis var. chinensis ‘Zesy002’ Kiwifruit

Plants ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1328
Author(s):  
Danielle Le Lievre ◽  
Rachelle Anderson ◽  
Helen Boldingh ◽  
Janine Cooney ◽  
Richard Seelye ◽  
...  
Keyword(s):  
Soluble Sugar ◽  
Consumer Acceptance ◽  
Sugar Accumulation ◽  
Actinidia Chinensis ◽  
Ripe Fruit ◽  
High Carbohydrate ◽  
Control Fruit ◽  
Low Carbohydrate ◽  
Final Weight ◽  
Metabolite Accumulation

Consumer acceptance of fruit is determined by size, flavour and ripeness. In this study we investigated how altering the carbohydrate supply to Actinidia chinensis var. chinensis ‘Zesy002′ kiwifruit altered the balance between growth and accumulation of metabolites. Canes were phloem girdled and fruit thinned to a leaf-to-fruit ratio (L:F) of either 2 (Low carbohydrate) or 6 (High carbohydrate) at either 38 (Early) or 86 (Late) days after anthesis (DAA) and compared with ungirdled control canes with a L:F of 3. Fruit growth, metabolite accumulation, cytokinin concentrations and maturation were monitored and the sensory attributes of ripe fruit were assessed. The final weight of Early-High and Late-High carbohydrate fruit was 38% and 16% greater compared with control fruit. High carbohydrate fruit had increased starch,soluble sugar and cytokinin concentrations and fruit began to mature earlier and those with a Low carbohydrate had decreased concentrations and matured later compared with control fruit. Control fruit were described by consumers as more acidic and under-ripe compared with those from Early-High carbohydrate canes, but as sweeter than those from Low carbohydrate canes. This study showed that carbohydrate supply can have a major impact on the growth, sugar accumulation and maturity of ‘Zesy002′ fruit sinks.

scholarly journals Further improvement in glycemic control after switching from exenatide two times per day to exenatide once-weekly autoinjected suspension in patients with type 2 diabetes: 52-week results from the DURATION-NEO-1 study

2020 ◽  
Vol 8 (1) ◽  
pp. e000773
Author(s):  
Carol H Wysham ◽  
Julio Rosenstock ◽  
Marion L Vetter ◽  
Hui Wang ◽  
Elise Hardy ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Phase Iii ◽  
Open Label ◽  
Open Label Study ◽  
Registration Number ◽  
Efficacy Measures ◽  
Design And Methods ◽  
To Receive

IntroductionInvestigate the effects of switching from two times per day exenatide to once-weekly exenatide administered by autoinjector (exenatide once-weekly suspension by autoinjector (QWS-AI)) or treatment with exenatide QWS-AI for 1 year.Research design and methodsIn this phase III open-label study, adults with type 2 diabetes were randomized to receive exenatide QWS-AI (2 mg) or exenatide two times per day (5 mcg for 4 weeks, followed by 10 mcg) for 28 weeks. During a subsequent non-randomized 24-week extension, patients who received exenatide two times per day were switched to exenatide QWS-AI and those randomized to exenatide QWS-AI continued this treatment. Efficacy measures included changes from baseline in glycated hemoglobin (A1C), fasting plasma glucose (FPG), and body weight.ResultsIn total, 315 patients (mean baseline A1C of 8.5%) completed the initial 28 weeks of randomized treatment with exenatide QWS-AI (n=197) or exenatide two times per day (n=118) and were included in the 24-week extension (mean A1C of 7.0% and 7.3%, respectively, at week 28). From weeks 28–52, patients who switched from exenatide two times per day to exenatide QWS-AI had additional A1C reductions of approximately 0.5% (mean A1C change from baseline of –1.4% at week 52) and further reductions from baseline in FPG. Patients who continued exenatide QWS-AI treatment for 52 weeks showed clinically relevant A1C reductions (mean A1C change from baseline of –1.3% at week 52). Body-weight reductions achieved through week 28 were sustained at week 52 in both groups. There were no unexpected safety concerns or changes in the safety profile among patients who switched from exenatide two times per day to exenatide QWS-AI or those who continued exenatide QWS-AI treatment for 52 weeks.ConclusionsSwitching from exenatide two times per day to exenatide QWS-AI resulted in further A1C reductions and maintenance of earlier decreases in body weight, while continued therapy with exenatide QWS-AI for 52 weeks maintained A1C and body-weight reductions, without additional safety or tolerability concerns.Trial registration numberNCT01652716.

scholarly journals Effects of Palm Stearin versus Butter in the Context of Low-Carbohydrate/High-Fat and High-Carbohydrate/Low-Fat Diets on Circulating Lipids in a Controlled Feeding Study in Healthy Humans

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1944
Author(s):  
Parker N. Hyde ◽  
Teryn N. Sapper ◽  
Richard A. LaFountain ◽  
Madison L. Kackley ◽  
Alex Buga ◽  
...  
Keyword(s):  
Particle Distribution ◽  
Oxidized Ldl ◽  
Saturated Fatty Acids ◽  
Density Lipoprotein ◽  
Palm Stearin ◽  
High Fat ◽  
Low Fat ◽  
High Carbohydrate ◽  
Ldl Particles ◽  
Low Carbohydrate

Background. Foods rich in saturated fatty acids (SFAs) have been discouraged by virtue of their cholesterol-raising potential, but this effect is modulated by the food source and background level of carbohydrate. Objective. We aimed to compare the consumption of palm stearin (PS) versus butter on circulating cholesterol responses in the setting of both a low-carbohydrate/high-fat (LC/HF) and high-carbohydrate/low-fat (HC/LF) diet in healthy subjects. We also explored effects on plasma lipoprotein particle distribution and fatty acid composition. Methods. We performed a randomized, controlled-feeding, cross-over study that compared a PS- versus a Butter-based diet in a group of normocholesterolemic, non-obese adults. A controlled canola oil-based ‘Run-In’ diet preceded the experimental PS and Butter diets. All diets were eucaloric, provided for 3-weeks, and had the same macronutrient distribution but varied in primary fat source (40% of the total fat). The same Run-In and cross-over experiments were done in two separate groups who self-selected to either a LC/HF (n = 12) or a HC/LF (n = 12) diet track. The primary outcomes were low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein (HDL)-C, triglycerides, and LDL particle distribution. Results. Compared to PS, Butter resulted in higher LDL-C in both the LC/HF (13.4%, p = 0.003) and HC/LF (10.8%, p = 0.002) groups, which was primarily attributed to large LDL I and LDL IIa particles. There were no differences between PS and Butter in HDL-C, triglycerides, or small LDL particles. Oxidized LDL was lower after PS than Butter in LC/HF (p = 0.011), but not the HC/LF group. Conclusions. These results demonstrate that Butter raises LDL-C relative to PS in healthy normocholesterolemic adults regardless of background variations in carbohydrate and fat, an effect primarily attributed to larger cholesterol-rich LDL particles.

scholarly journals Examination of Potential Mechanisms in the Enhancement of Cerebral Blood Flow by Hypoglycemia and Pharmacological Doses of Deoxyglucose

1997 ◽  
Vol 17 (1) ◽  
pp. 54-63 ◽  
Author(s):  
Naoaki Horinaka ◽  
Nicole Artz ◽  
Jane Jehle ◽  
Shinichi Takahashi ◽  
Charles Kennedy ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Glucose Metabolism ◽  
Plasma Glucose ◽  
Plasma Lactate ◽  
Insulin Hypoglycemia ◽  
Glucose Levels ◽  
Arterial Blood ◽  
Arterial Plasma

Cerebral blood flow (CBF) rises when the glucose supply to the brain is limited by hypoglycemia or glucose metabolism is inhibited by pharmacological doses of 2-deoxyglucose (DG). The present studies in unanesthetized rats with insulin-induced hypoglycemia show that the increases in CBF, measured with the [14C]iodoantipyrine method, are relatively small until arterial plasma glucose levels fall to 2.5 to 3.0 m M, at which point CBF rises sharply. A direct effect of insulin on CBF was excluded; insulin administered under euglycemic conditions maintained by glucose injections had no effects on CBF. Insulin administration raised plasma lactate levels and decreased plasma K+ and HCO3– concentrations and arterial pH. These could not, however, be related to the increased CBF because insulin under euglycemic conditions had similar effects without affecting CBF; furthermore, the inhibition of brain glucose metabolism with pharmacological doses (200 mg/kg intravenously) of DG increased CBF, just like insulin hypoglycemia, without altering plasma lactate and K+ levels and arterial blood gas tensions and pH. Nitric oxide also does not appear to mediate the increases in CBF. Chronic blockade of nitric oxide synthase activity by twice daily i.p. injections of NG-nitro-L-arginine methyl ester for 4 days or acutely by a single i.v. injection raised arterial blood pressure and lowered CBF in normoglycemic, hypoglycemic, and DG-treated rats but did not significantly reduce the increases in CBF due to insulin-induced hypoglycemia (arterial plasma glucose levels, 2.5-3 m M) or pharmacological doses of deoxyglucose.

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