scholarly journals Evaluation of second phase insulin secretion with simple surrogates derived from the mixed meal tolerance test in patients with type 2 diabetes

2013 ◽  
Vol 60 (9) ◽  
pp. 1077-1084 ◽  
Author(s):  
Wei-Cheng Lian ◽  
Jiunn-Diann Lin ◽  
Jin-Biou Chang ◽  
Chun-Hsien Hsu ◽  
Chun Pei ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Tolerance Test ◽  
Second Phase ◽  
Mixed Meal ◽  
Meal Tolerance Test ◽  
Mixed Meal Tolerance Test

scholarly journals Comparison of consumption behavior and appetite sensations among patients with type 2 diabetes mellitus after bariatric surgery

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3090 ◽  
Author(s):  
Chun Yeh ◽  
Hsien-Hao Huang ◽  
Shu-Chun Chen ◽  
Tung-Fang Chen ◽  
Kong-Han Ser ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Tolerance Test ◽  
Mixed Meal ◽  
C Peptide ◽  
Meal Tolerance Test ◽  
Mixed Meal Tolerance Test ◽  
One Year ◽  
Desire To Eat

Background The promising postsurgical weight loss and remission of type 2 diabetes (T2D) from bariatric surgery can be attributed to modified eating physiology after surgical procedures. We sought to investigate the changes in the parameters of consumption behaviors and appetite sensations induced by a mixed meal tolerance test, and to correlate these alterations with age, body mass index, C-peptide levels, and duration of T2D 1 year after bariatric surgery. Methods A total of 16 obese patients with T2D who underwent mini-gastric bypass (GB) and 16 patients who underwent sleeve gastrectomy (SG) were enrolled in this study and evaluated using a mixed meal tolerance test one year after surgery. A visual analogue scale was used for scoring appetite sensation at different time points. The area under the curve (AUC) and the incremental or decremental AUC (ΔAUC) were compared between the two groups. Results One year after surgery, a decreasing trend in the consumption time was observed in the GB group compared to the SG group, while the duration of T2D before surgery was negatively correlated with the post-operative consumed time in those after GB. Patients who underwent GB had significantly higher fasting scores for fullness and desire to eat, higher AUC0′–180′ of scores for desire to eat, as well as more effective post-meal suppression of hunger and desire to eat compared with those undergoing SG one year after surgery. Post-operative C-peptide levels were negatively correlated with ΔAUC0′–180′ for hunger and ΔAUC0′–180′ for desire to eat in the GB group, while negatively correlated with ΔAUC0′–180′ for fullness in the SG group. Discussion Patients with T2D after either GB or SG exhibit distinct nutrient-induced consumption behaviors and appetite sensations post-operatively, which may account for the differential effects on weight loss and glycemic control after different surgery.

scholarly journals Post-load glucose subgroups and associated metabolic traits in individuals with type 2 diabetes: An IMI-DIRECT study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242360
Author(s):  
Morgan Obura ◽  
Joline W. J. Beulens ◽  
Roderick Slieker ◽  
Anitra D. M. Koopman ◽  
Trynke Hoekstra ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Tolerance Test ◽  
Diabetes Research ◽  
Mixed Meal ◽  
Meal Tolerance Test ◽  
Metabolic Traits ◽  
Direct Study ◽  
Mixed Meal Tolerance Test ◽  
Glucose Curve

Aim Subclasses of different glycaemic disturbances could explain the variation in characteristics of individuals with type 2 diabetes (T2D). We aimed to examine the association between subgroups based on their glucose curves during a five-point mixed-meal tolerance test (MMT) and metabolic traits at baseline and glycaemic deterioration in individuals with T2D. Methods The study included 787 individuals with newly diagnosed T2D from the Diabetes Research on Patient Stratification (IMI-DIRECT) Study. Latent class trajectory analysis (LCTA) was used to identify distinct glucose curve subgroups during a five-point MMT. Using general linear models, these subgroups were associated with metabolic traits at baseline and after 18 months of follow up, adjusted for potential confounders. Results At baseline, we identified three glucose curve subgroups, labelled in order of increasing glucose peak levels as subgroup 1–3. Individuals in subgroup 2 and 3 were more likely to have higher levels of HbA1c, triglycerides and BMI at baseline, compared to those in subgroup 1. At 18 months (n = 651), the beta coefficients (95% CI) for change in HbA1c (mmol/mol) increased across subgroups with 0.37 (-0.18–1.92) for subgroup 2 and 1.88 (-0.08–3.85) for subgroup 3, relative to subgroup 1. The same trend was observed for change in levels of triglycerides and fasting glucose. Conclusions Different glycaemic profiles with different metabolic traits and different degrees of subsequent glycaemic deterioration can be identified using data from a frequently sampled mixed-meal tolerance test in individuals with T2D. Subgroups with the highest peaks had greater metabolic risk.

scholarly journals Multi-parameter comparison of a standardized mixed meal tolerance test in healthy and type 2 diabetic subjects: the PhenFlex challenge

2017 ◽  
Vol 12 (1) ◽  
Author(s):  
Suzan Wopereis ◽  
Johanna H. M. Stroeve ◽  
Annette Stafleu ◽  
Gertruud C. M. Bakker ◽  
Jacobus Burggraaf ◽  
...  
Keyword(s):  
Tolerance Test ◽  
Mixed Meal ◽  
Meal Tolerance Test ◽  
Mixed Meal Tolerance Test ◽  
Type 2 Diabetic

ONE-HOUR MEAL TOLERANCE TEST TO ASSESS WITHDRAWAL OF INSULIN THERAPY IN OVERWEIGHT PATIENTS WITH TYPE 2 DIABETES

2001 ◽  
Vol 7 (4) ◽  
pp. 256-261 ◽  
Author(s):  
Dinesh Kumar, MD, FACE ◽  
Teresa Luna-Lollie, RN, CDE ◽  
Sarah Madha, RD, CDE
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Tolerance Test ◽  
Meal Tolerance Test

scholarly journals Effects of mixed meal tolerance test on gastric emptying, glucose and lipid homeostasis in obese nonhuman primates

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kamal Albarazanji ◽  
Andrea R. Nawrocki ◽  
Bin Gao ◽  
Xiaoli Wang ◽  
Yixin Wang ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Glucose Homeostasis ◽  
Plasma Glucose ◽  
Nonhuman Primates ◽  
Surrogate Marker ◽  
Tolerance Test ◽  
Mixed Meal ◽  
C Peptide ◽  
Meal Tolerance Test ◽  
Mixed Meal Tolerance Test

AbstractMeal ingestion elicits a variety of neuronal, physiological and hormonal responses that differ in healthy, obese or diabetic individuals. The mixed meal tolerance test (MMTT) is a well-established method to evaluate pancreatic β-cell reserve and glucose homeostasis in both preclinical and clinical research in response to calorically defined meal. Nonhuman primates (NHPs) are highly valuable for diabetic research as they can naturally develop type 2 diabetes mellitus (T2DM) in a way similar to the onset and progression of human T2DM. The purpose of this study was to investigate the reproducibility and effects of a MMTT containing acetaminophen on plasma glucose, insulin, C-peptide, incretin hormones, lipids, acetaminophen appearance (a surrogate marker for gastric emptying) in 16 conscious obese cynomolgus monkeys (Macaca fascicularis). Plasma insulin, C-peptide, TG, aGLP-1, tGIP, PYY and acetaminophen significantly increased after meal/acetaminophen administration. A subsequent study in 6 animals showed that the changes of plasma glucose, insulin, C-peptide, lipids and acetaminophen were reproducible. There were no significant differences in responses to the MMTT among the obese NHPs with (n = 11) or without (n = 5) hyperglycemia. Our results demonstrate that mixed meal administration induces significant secretion of several incretins which are critical for maintaining glucose homeostasis. In addition, the responses to the MMTTs are reproducible in NHPs, which is important when the MMTT is used for evaluating post-meal glucose homeostasis in research.

Effects on insulin secretion and insulin action of a 48-h reduction of plasma free fatty acids with acipimox in nondiabetic subjects genetically predisposed to type 2 diabetes

2007 ◽  
Vol 292 (6) ◽  
pp. E1775-E1781 ◽  
Author(s):  
Kenneth Cusi ◽  
Sangeeta Kashyap ◽  
Amalia Gastaldelli ◽  
Mandeep Bajaj ◽  
Eugenio Cersosimo
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Family History ◽  
Second Phase ◽  
Β Cell ◽  
C Peptide ◽  
Hyperglycemic Clamp ◽  
History Of ◽  
Plasma Ffa

Elevated plasma FFA cause β-cell lipotoxicity and impair insulin secretion in nondiabetic subjects predisposed to type 2 diabetes mellitus [T2DM; i.e., with a strong family history of T2DM (FH+)] but not in nondiabetic subjects without a family history of T2DM. To determine whether lowering plasma FFA with acipimox, an antilipolytic nicotinic acid derivative, may enhance insulin secretion, nine FH+ volunteers were admitted twice and received in random order either acipimox or placebo (double-blind) for 48 h. Plasma glucose/insulin/C-peptide concentrations were measured from 0800 to 2400. On day 3, insulin secretion rates (ISRs) were assessed during a +125 mg/dl hyperglycemic clamp. Acipimox reduced 48-h plasma FFA by 36% ( P < 0.001) and increased the plasma C-peptide relative to the plasma glucose concentration or ΔC-peptide/Δglucose AUC (+177%, P = 0.02), an index of improved β-cell function. Acipimox improved insulin sensitivity (M/I) 26.1 ± 5% ( P < 0.04). First- (+19 ± 6%, P = 0.1) and second-phase (+31 ± 6%, P = 0.05) ISRs during the hyperglycemic clamp also improved. This was particularly evident when examined relative to the prevailing insulin resistance [1/(M/I)], as both first- and second-phase ISR markedly increased by 29 ± 7 ( P < 0.05) and 41 ± 8% ( P = 0.02). There was an inverse correlation between fasting FFA and first-phase ISR ( r2 = 0.31, P < 0.02) and acute (2–4 min) glucose-induced insulin release after acipimox ( r2 =0.52, P < 0.04). In this proof-of-concept study in FH+ individuals predisposed to T2DM, a 48-h reduction of plasma FFA improves day-long meal and glucose-stimulated insulin secretion. These results provide additional evidence for the important role that plasma FFA play regarding insulin secretion in FH+ subjects predisposed to T2DM.

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