Effect of 2 Liquid Nutritional Supplements for Diabetes Patients on Postprandial Glucose, Insulin Secretion, and Insulin Sensitivity in Healthy Individuals

Objective.In nondiabetic healthy individuals, insulin secretion and sensitivity are linked by a negative feedback loop characterized by a hyperbolic function. We aimed to study the association of traditional insulin resistance (IR) factors with insulin secretion and sensitivity, and to determine whether the hyperbolic equilibrium of this relation is preserved in patients with rheumatoid arthritis (RA).Methods.This was a cross-sectional study encompassing 361 nondiabetic individuals: 151 with RA and 210 controls. Insulin, C-peptide, and IR indices by homeostatic model (HOMA2) were assessed. A multivariable analysis was performed to evaluate the differences in the correlation of traditional IR-related factors with glucose homeostasis molecules, as well as IR indices between patients and controls. Nonlinear regression analysis was used to assess the hyperbolic relation of insulin sensitivity and secretion.Results.HOMA2-IR indices were higher in patients with RA than controls. Hepatic insulin extraction, as assessed by the insulin:C-peptide molar ratio, was lower in patients with RA after multivariable analysis (0.08 ± 0.02 vs 0.14 ± 0.07, p < 0.001). Traditional IR-related factors showed significantly lower adjusted correlation coefficients with IR indices in patients with RA. The association between insulin sensitivity and secretion showed a different hyperbolic relation in patients with RA: the variability explained by the curve was lower in RA (nonlinear r2= 0.845 vs r2= 0.928, p = 0.001) and β coefficients (−0.74, 95% CI −0.77 to −0.70 vs −1.09, 95% CI −1.17 to −1.02, ng/ml, p < 0.001) were different in RA.Conclusion.The traditional factors associated with IR in healthy individuals are less related to IR in patients with RA. Insulin sensitivity and secretion yield a different hyperbolic equilibrium in RA.

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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

Diabetes Obesity and Metabolism ◽

10.1111/j.1463-1326.2005.00512.x ◽

2006 ◽

Vol 8 (3) ◽

pp. 331-335 ◽

Cited By ~ 12

Author(s):

M. Gonzalez-Ortiz ◽

E. Martinez-Abundis ◽

E. Hernandez-Salazar ◽

A. M. Kam-Ramos ◽

J. A. Robles-Cervantes

Keyword(s):

Diabetes Mellitus ◽

Insulin Secretion ◽

Insulin Sensitivity ◽

Healthy Subjects ◽

Postprandial Glucose

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The Relationship between Serum 25-Hydroxy Vitamin D and Insulin Sensitivity and β-Cell Function in Newly Diagnosed Type 2 Diabetes

Journal of Diabetes Research ◽

10.1155/2015/636891 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 10

Author(s):

Yuan Gao ◽

Xinchi Wu ◽

Qi Fu ◽

Yanyun Li ◽

Tao Yang ◽

...

Keyword(s):

Type 2 Diabetes ◽

Vitamin D ◽

Insulin Secretion ◽

Insulin Sensitivity ◽

Cell Function ◽

Newly Diagnosed ◽

25 Hydroxy Vitamin D ◽

The Relationship ◽

Diabetes Patients

The aim of this study was to investigate the relationship between serum 25-hydroxy vitamin D (25-OHD) and insulin sensitivity andβ-cell function in newly diagnosed type 2 diabetes. 395 newly diagnosed type 2 diabetes patients were enrolled in this study. Venous blood samples were collected at 0 min, 30 min, and 120 min of OGTT to measure serum glucose and insulin. Matsuda ISI and HOMA-IR were used to determine insulin sensitivity. The ratio of 0–120 min area under curve of insulin to glucose (insulin release index, INSR) was calculated as surrogate index ofβ-cell insulin secretion function. The products of insulin secretion indices multiplied by Matsuda insulin sensitivity index were used as disposition indices. Patients were divided into three groups according to tertiles (T1, T2, and T3) of 25-OHD concentration. There was significant difference among three groups for HOMA-IR, Matsuda ISI, and INSR. HOMA-IR, Matsuda ISI, INSR, and DI were undifferentiated among three groups in male patients. But HOMA-IR, Matsuda ISI, and INSR were significantly different among three groups in female patients after being adjusted by confounding factors. In conclusion, serum 25-OHD is associated with insulin sensitivity andβ-cell function for female newly diagnosed type 2 diabetes patients, and the association is ambiguous in males.

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Role of nuclear receptors in the modulation of insulin secretion in lipid-induced insulin resistance

Biochemical Society Transactions ◽

10.1042/bst0360891 ◽

2008 ◽

Vol 36 (5) ◽

pp. 891-900 ◽

Cited By ~ 31

Author(s):

Mary C. Sugden ◽

Mark J. Holness

Keyword(s):

Insulin Resistance ◽

Insulin Secretion ◽

Insulin Sensitivity ◽

Nuclear Receptors ◽

Feedback Loop ◽

Farnesoid X Receptor ◽

Lipid Lowering ◽

Whole Body ◽

Glucose Disposal ◽

Healthy Individuals

In healthy individuals, a hyperbolic relationship exists between whole-body insulin-sensitivity and insulin secretion. Thus, for any difference in insulin-sensitivity, a reciprocal proportionate change occurs in insulin secretion. Such a feedback loop is evident in healthy individuals ingesting diets high in saturated fat and in late pregnancy where, despite lipid-induced insulin resistance, glucose tolerance is maintained through augmented GSIS (glucose-stimulated insulin secretion). NRs (nuclear receptors) are members of a superfamily of ligand-regulated and orphan transcription factors. On activation by a cognate ligand, many ligand-activated NRs recruit the RXR (retinoid X receptor) for heterodimer formation. Such NRs include the PPARs (peroxisome-proliferator-activated receptors), which are involved in lipid sensing and liporegulation. PPARs exert important lipid-lowering effects in vivo, thereby opposing the development of lipid-induced insulin resistance by relieving the inhibition of insulin-stimulated glucose disposal by muscle and lowering the necessity for augmented GSIS to counter lipid-induced insulin resistance. Long-chain fatty acids are proposed as natural PPAR ligands and some specific endogenous pathways of lipid metabolism are believed to generate PPAR agonists. Other NRs, e.g. the LXR (liver X receptor), which senses expansion of the metabolically active pool of cholesterol, and the FXR (farnesoid X receptor; NR1H4), which, like the LXR, is involved in sterol metabolism, also modulate systemic lipid levels and insulin-sensitivity. In this review, we discuss how these NRs impact insulin secretion via effects on the insulin-sensitivity–insulin secretion feedback loop and, in some cases, via direct effects on the islet itself. In addition, we discuss interactions between these nutrient/metabolite-responsive NRs and NRs that are central to the action of metabolically important hormones, including (i) the glucocorticoid receptor, critical for maintaining glucose homoeostasis in stress, inflammation and during fasting, and (ii) the thyroid hormone receptors, vital for maintenance of oxidative functions. We present data indicating that the RXR occupies a key role in directly modulating islet function and that its heterodimerization with at least two of its partners modulates GSIS.

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T01-P-008 Effects of fish-oil on insulin sensitivity and insulin secretion in healthy individuals in relation to the N-6/N-3 ratio of serum phospholipids

Atherosclerosis Supplements ◽

10.1016/s1567-5688(05)80525-2 ◽

2005 ◽

Vol 6 (1) ◽

pp. 135

Author(s):

R. Giacco ◽

V. Cuomo ◽

B. Vessby ◽

M. Uusitupa ◽

K. Hermansen ◽

...

Keyword(s):

Insulin Secretion ◽

Insulin Sensitivity ◽

Fish Oil ◽

Healthy Individuals ◽

Serum Phospholipids

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Regulation of glucose metabolism in nondiabetic, metabolically obese normal-weight Asians

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00382.2017 ◽

2018 ◽

Vol 314 (5) ◽

pp. E494-E502 ◽

Cited By ~ 12

Author(s):

Cherlyn Ding ◽

Zhiling Chan ◽

Yu Chung Chooi ◽

John Choo ◽

Suresh Anand Sadananthan ◽

...

Keyword(s):

Insulin Resistance ◽

Insulin Secretion ◽

Insulin Sensitivity ◽

Body Fat ◽

Postprandial Glucose ◽

Normal Weight ◽

Increased Risk ◽

Total Body Fat ◽

Metabolically Obese Normal Weight ◽

Total Body

Type 2 diabetes in Asia occurs largely in the absence of obesity. The metabolically obese normal-weight (MONW) phenotype refers to lean subjects with metabolic dysfunction that is typically observed in people with obesity and is associated with increased risk for diabetes. Previous studies evaluated MONW subjects who had greater body mass index (BMI) or total body fat than respective control groups, making interpretation of the results difficult. We evaluated insulin sensitivity (hyperinsulinemic-euglycemic clamp); insulin secretion (mixed meal with oral minimal modeling); intra-abdominal, muscle, and liver fat contents (magnetic resonance); and fasting and postprandial glucose and insulin concentrations in 18 MONW subjects and 18 metabolically healthy controls matched for age (43 ± 3 and 40 ± 3 yr; P = 0.52), BMI (both 22 ± 1 kg/m2; P = 0.69), total body fat (17 ± 1 and 16 ± 1 kg; P = 0.33), and sex (9 men and 9 women in each group). Compared with controls, MONW subjects had an approximately twofold greater visceral adipose tissue volume and an approximately fourfold greater intrahepatic fat content (but similar muscle fat), 20–30% lower glucose disposal rates and insulin sensitivity, and 30–40% greater insulin secretion rates (all P < 0.05). The disposition index, fasting glucose, and HbA1c concentrations were not different between groups, whereas postprandial glucose and insulin concentrations were ~15% and ~65% greater, respectively, in MONW than control subjects (both P < 0.05). We conclude that the MONW phenotype is associated with accumulation of fat in the intra-abdominal area and the liver, profound insulin resistance, but also a robust β-cell insulin secretion response that compensates for insulin resistance and helps maintain glucose homeostasis.

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