scholarly journals A High-Protein Breakfast Induces Greater Insulin and Glucose-Dependent Insulinotropic Peptide Responses to a Subsequent Lunch Meal in Individuals with Type 2 Diabetes

2014 ◽  
Vol 145 (3) ◽  
pp. 452-458 ◽  
Author(s):  
Young-Min Park ◽  
Timothy D Heden ◽  
Ying Liu ◽  
Lauryn M Nyhoff ◽  
John P Thyfault ◽  
...  
Keyword(s):  
Area Under The Curve ◽  
Postprandial Glucose ◽  
High Protein ◽  
Glucose Response ◽  
C Peptide ◽  
High Carbohydrate ◽  
Glucagon Like Peptide 1 ◽  
Insulinotropic Peptide ◽  
Type 2 Diabetic

Abstract Background: The previous meal modulates the postprandial glycemic responses to a subsequent meal; this is termed the second-meal phenomenon. Objective: This study examined the effects of high-protein vs. high-carbohydrate breakfast meals on the metabolic and incretin responses after the breakfast and lunch meals. Methods: Twelve type 2 diabetic men and women [age: 21–55 y; body mass index (BMI): 30–40 kg/m2] completed two 7-d breakfast conditions consisting of 500-kcal breakfast meals as protein (35% protein/45% carbohydrate) or carbohydrate (15% protein/65% carbohydrate). On day 7, subjects completed an 8-h testing day. After an overnight fast, the subjects consumed their respective breakfast followed by a standard 500-kcal high-carbohydrate lunch meal 4 h later. Blood samples were taken throughout the day for assessment of 4-h postbreakfast and 4-h postlunch total area under the curve (AUC) for glucose, insulin, C-peptide, glucagon, glucose-dependent insulinotropic peptide (GIP), and glucagon-like peptide 1 (GLP-1). Results: Postbreakfast glucose and GIP AUCs were lower after the protein (17%) vs. after the carbohydrate (23%) condition (P < 0.05), whereas postbreakfast insulin, C-peptide, glucagon, and GLP-1 AUCs were not different between conditions. A protein-rich breakfast may reduce the consequences of hyperglycemia in this population. Postlunch insulin, C-peptide, and GIP AUCs were greater after the protein condition vs. after the carbohydrate condition (second-meal phenomenon; all, P < 0.05), but postlunch AUCs were not different between conditions. The overall glucose, glucagon, and GLP-1 responses (e.g., 8 h) were greater after the protein condition vs. after the carbohydrate condition (all, P < 0.05). Conclusions: In type 2 diabetic individuals, compared with a high-carbohydrate breakfast, the consumption of a high-protein breakfast meal attenuates the postprandial glucose response and does not magnify the response to the second meal. Insulin, C-peptide, and GIP concentrations demonstrate the second-meal phenomenon and most likely aid in keeping the glucose concentrations controlled in response to the subsequent meal. The trial was registered at www.clinicaltrials.gov/ct2/show/NCT02180646 as NCT02180646.

scholarly journals Lupin and soya reduce glycaemia acutely in type 2 diabetes

2011 ◽  
Vol 106 (7) ◽  
pp. 1045-1051 ◽  
Author(s):  
Emma R. Dove ◽  
Trevor A. Mori ◽  
Gerard T. Chew ◽  
Anne E. Barden ◽  
Richard J. Woodman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
G Protein ◽  
Insulin Response ◽  
Postprandial Glucose ◽  
Serum Glucose ◽  
Glycaemic Response ◽  
Glucose Response ◽  
C Peptide ◽  
Type 2 Diabetic

Addition of fibre or protein to carbohydrate-rich foods can reduce the glycaemic response to those foods. This may assist with glycaemic management in individuals with type 2 diabetes. Lupin is a legume rich in fibre and protein. We assessed the acute effects of lupin- and soya-based beverages on glucose and insulin responses in type 2 diabetic individuals. We hypothesised that the lupin and soya beverages would lower the acute glycaemic response compared with a control beverage containing no protein or fibre, and that lupin would reduce the postprandial glucose more than soya. In a randomised, controlled, cross-over trial, twenty-four diabetic adults (nineteen men and five women) attended three testing sessions, each 1 week apart. At each session, participants consumed a beverage containing 50 g glucose (control), 50 g glucose plus lupin kernel flour with 12·5 g fibre and 22 g protein (lupin), or 50 g glucose plus 12·5 g fibre and 22 g protein from soya isolates (soya). Serum glucose, insulin and C-peptide were measured periodically for 4 h following beverage consumption. Compared with the control beverage, the 4 h post-beverage glucose response was lower (P < 0·001), and the 4 h post-beverage insulin and C-peptide responses were higher (P < 0·001) for lupin and soya. Glucose (P = 0·25) and C-peptide (P = 0·07) responses did not differ significantly between lupin and soya, but lupin resulted in a lower insulin response compared with soya (P = 0·013). Adding lupin or soya to a carbohydrate-rich beverage reduces glycaemia acutely in type 2 diabetic individuals. This may have a beneficial role in glycaemic management.

scholarly journals Circulating Levels of the Soluble Receptor for AGE (sRAGE) during Escalating Oral Glucose Dosages and Corresponding Isoglycaemic i.v. Glucose Infusions in Individuals with and without Type 2 Diabetes

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2928
Author(s):  
Amelia K. Fotheringham ◽  
Jonatan I. Bagger ◽  
Danielle J. Borg ◽  
Domenica A. McCarthy ◽  
Jens J. Holst ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Area Under The Curve ◽  
Postprandial Glucose ◽  
Oral Glucose ◽  
Soluble Receptor ◽  
Incretin Hormone ◽  
Glycation End Products ◽  
Glucose Tolerance Tests ◽  
Glucagon Like Peptide 1

Postprandial glucose excursions are postulated to increase the risk for diabetes complications via the production of advanced glycation end products (AGEs). The soluble receptor of AGEs (sRAGE) likely acts as a decoy receptor, mopping up AGEs, diminishing their capacity for pro-inflammatory and pro-apoptotic signaling. Recent evidence suggests that AGEs and soluble receptor for AGEs (sRAGE) may be altered under postprandial and fasting conditions. Here, we investigated the effects of increasing oral glucose loads during oral glucose tolerance tests (OGTT) and matched isoglycaemic intravenous (i.v.) glucose infusions (IIGI) on circulating concentrations of sRAGE. Samples from eight individuals with type 2 diabetes and eight age-, gender-, and body mass index (BMI)-matched controls, all of whom underwent three differently dosed OGTTs (25 g, 75 g, and 125 g), and three matched IIGIs were utilised (NCT00529048). Serum concentrations of sRAGE were measured over 240 min during each test. For individuals with diabetes, sRAGE area under the curve (AUC0–240min) declined with increasing i.v. glucose dosages (p < 0.0001 for trend) and was lower during IIGI compared to OGTT at the 125 g dosage (p = 0.004). In control subjects, sRAGE AUC0–240min was only lower during IIGI compared to OGTT at the 25 g dose (p = 0.0015). sRAGE AUC0–240min was negatively correlated to AUC0–240min for the incretin hormone glucagon-like peptide −1 (GLP-1) during the 75 g OGTT and matched IIGI, but only in individuals with type 2 diabetes. These data suggest that gastrointestinal factors may play a role in regulating sRAGE concentrations during postprandial glucose excursions, thus warranting further investigation.

scholarly journals Add-on saxagliptin improves glycemic status among uncontrolled type 2 diabetes mellitus

2018 ◽  
Vol 6 (5) ◽  
pp. 1682
Author(s):  
Butungeshwar Pradhan ◽  
Chakradhar Majhi ◽  
Madhusmita Sahu
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Postprandial Glucose ◽  
Glycemic Status ◽  
Dipeptidyl Peptidase 4 ◽  
Spss Software ◽  
Glucagon Like Peptide 1 ◽  
Insulinotropic Peptide

Background: Type 2 diabetes mellitus (T2DM) have multiple pathophysiologic defects contributing to hyperglycemia. T2DM patients have insulin resistance with progressive β-cell failure and progressive insulin secretion defect. Dipeptidyl peptidase-4 (DPP-4) inhibitors target the incretin system. saxagliptin is a DPP-4 inhibitor slowing the degradation of Glucagon-like peptide-1 (GLP-1) and Glucose-dependent insulinotropic peptide (GIP) sustain the incretin effects. Aim was to know the add-on effects of saxagliptin among uncontrolled T2DM.Methods: A total of 71 uncontrolled T2DM patients on various antidiabetic therapies except incretin mimetic were consecutively selected for the study. Baseline fasting plasma glucose (FPG), 2hour postprandial glucose (PPG) and glycated hemoglobin (HbA1c) was measured. Saxagliptin orally 5mg/day was given after approval of ethical committee and FPG, 2hour PPG and HbA1c was measured at 12 weeks and 24 weeks. Data were collected and analyzed by ‘t’ test using SPSS software version 25.Results: Baseline FPG, 2hour PPG and HbA1c was 158.4±13.9mg%, 252.6±24.4mg% and 8.6±1.3% respectively. Percentage of patients achieved HbA1c of <7% at 12 weeks was 16.9% and 43.6% at 24 weeks (P <0.05). Adjusted mean difference in HbA1c was 0.73% at 12 weeks and 1.2 % at 24 weeks (P <0.05). Reduction of mean FPG, 2hour PPG and HbA1c was 154.48±13.8mg%, 240.31±26.8mg% and 7.93±1.1% at 12 weeks and 151.15±13.7mg%, 231.7±27mg% and 7.38±1% at 24 weeks respectively (P <0.05). Patients on insulin were better responded.Conclusions: Add-on saxagliptin improves all parameter of glycemic status in uncontrolled type 2 DM patients.

scholarly journals Exenatide can reduce glucose independent of islet hormones or gastric emptying

2008 ◽  
Vol 295 (2) ◽  
pp. E269-E277 ◽  
Author(s):  
Viorica Ionut ◽  
Dan Zheng ◽  
Darko Stefanovski ◽  
Richard N. Bergman
Keyword(s):  
Gastric Emptying ◽  
Portal Vein ◽  
Area Under The Curve ◽  
Neural Mechanism ◽  
Postprandial Glucose ◽  
Islet Hormones ◽  
Glucagon Suppression ◽  
Glucagon Like Peptide 1 ◽  
Long Acting

Exenatide is a long-acting glucagon-like peptide-1 (GLP-1) mimetic used in the treatment of type 2 diabetes. There is increasing evidence that GLP-1 can influence glycemia not only via pancreatic (insulinotropic and glucagon suppression) and gastric-emptying effects, but also via an independent mechanism mediated by portal vein receptors. The aim of our study was to investigate whether exenatide has an islet- and gastric-independent glycemia-reducing effect, similar to GLP-1. First, we administered mixed meals, with or without exenatide (20 μg sc) to dogs. Second, to determine whether exenatide-induced reduction in glycemia is independent of slower gastric emptying, in the same animals we infused glucose intraportally (to simulate meal test glucose appearance) with exenatide, exenatide + the intraportal GLP-1 receptor antagonist exendin-(9-39), or saline. Exenatide markedly decreased postprandial glucose: net 0- to 135-min area under the curve = +526 ± 315 and −536 ± 197 mg·dl−1·min−1 with saline and exenatide, respectively ( P < 0.05). Importantly, the decrease in plasma glucose occurred without a corresponding increase in postprandial insulin but was accompanied by delayed gastric emptying and lower glucagon. Significantly lower glycemia was induced by intraportal glucose infusion with exenatide than with saline (92 ± 1 vs. 97 ± 1 mg/dl, P < 0.001) in the absence of hyperinsulinemia or glucagon suppression. The exenatide-induced lower glycemia was partly reversed by intraportal exendin-(9-39): 95 ± 3 and 92 ± 3 mg/dl with exenatide + antagonist and exenatide, respectively ( P < 0.01). Our results suggest that, similar to GLP-1, exenatide lowers glycemia via a novel mechanism independent of islet hormones and slowing of gastric emptying. We hypothesize that receptors in the portal vein, via a neural mechanism, increase glucose clearance independent of islet hormones.

scholarly journals Chilled Potatoes Decrease Postprandial Glucose, Insulin, and Glucose-dependent Insulinotropic Peptide Compared to Boiled Potatoes in Females with Elevated Fasting Glucose and Insulin

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2066 ◽  
Author(s):  
Mindy A Patterson ◽  
Joy Nolte Fong ◽  
Madhura Maiya ◽  
Stephanie Kung ◽  
Araz Sarkissian ◽  
...  
Keyword(s):  
Peptide Yy ◽  
Fasting Glucose ◽  
Area Under The Curve ◽  
Postprandial Glucose ◽  
Cooking Method ◽  
Postprandial Glycemia ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Insulinotropic Peptide ◽  
Randomized Crossover Study

Resistant starch (RS) has been shown to improve postprandial glycemia and insulin sensitivity in adults with metabolic syndrome. RS is found naturally in potatoes, where the amount varies based on cooking method and serving temperature. Thirty females with a mean BMI of 32.8 ± 3.7 kg/m2, fasting glucose of 110.5 mg/dL, and insulin of 10.3 µIU/L, completed this randomized, crossover study. A quantity of 250 g of boiled (low RS) and baked then chilled (high RS) russet potatoes were consumed on two separate occasions. Glycemic (glucose and insulin) and incretin response, subjective satiety, and dietary intake were measured. Results showed that the chilled potato elicited significant reductions at 15 and 30 min in glucose (4.8% and 9.2%), insulin (25.8% and 22.6%), and glucose-dependent insulinotropic peptide (GIP) (41.1% and 37.6%), respectively. The area under the curve for insulin and GIP were significantly lower after the chilled potato, but no differences were seen in glucose, glucagon-like peptide-1, and peptide YY, or overall subjective satiety. A higher carbohydrate and glycemic index but lower fat diet was consumed 48-hours following the chilled potato than the boiled potato. This study demonstrates that consuming chilled potatoes higher in RS can positively impact the glycemic response in females with elevated fasting glucose and insulin.

scholarly journals Body Mass Index, Fasting Plasma Glucose Levels, and C-peptide Levels as Predictors of the Future Insulin Use in Japanese Type 2 Diabetic Patients

2010 ◽  
Vol 57 (3) ◽  
pp. 237-244 ◽  
Author(s):  
Atsushi GOTO ◽  
Maki TAKAICHI ◽  
Miyako KISHIMOTO ◽  
Yoshihiko TAKAHASHI ◽  
Hiroshi KAJIO ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
C Peptide ◽  
Glucose Levels ◽  
Insulin Use ◽  
Type 2 Diabetic

scholarly journals A carbohydrate-reduced high-protein diet acutely decreases postprandial and diurnal glucose excursions in type 2 diabetes patients

2018 ◽  
Vol 119 (8) ◽  
pp. 910-917 ◽  
Author(s):  
Amirsalar Samkani ◽  
Mads J. Skytte ◽  
Daniel Kandel ◽  
Stine Kjaer ◽  
Arne Astrup ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Gut Hormones ◽  
High Protein Diet ◽  
Postprandial Glucose ◽  
High Protein ◽  
Moderate Reduction ◽  
Simple Substitution

AbstractThe aim of the study was to assess whether a simple substitution of carbohydrate in the conventionally recommended diet with protein and fat would result in a clinically meaningful reduction in postprandial hyperglycaemia in subjects with type 2 diabetes mellitus (T2DM). In all, sixteen subjects with T2DM treated with metformin only, fourteen male, with a median age of 65 (43–70) years, HbA1cof 6·5 % (47 mmol/l) (5·5–8·3 % (37–67 mmol/l)) and a BMI of 30 (sd4·4) kg/m2participated in the randomised, cross-over study. A carbohydrate-reduced high-protein (CRHP) diet was compared with an iso-energetic conventional diabetes (CD) diet. Macronutrient contents of the CRHP/CD diets consisted of 31/54 % energy from carbohydrate, 29/16 % energy from protein and 40/30 % energy from fat, respectively. Each diet was consumed on 2 consecutive days in a randomised order. Postprandial glycaemia, pancreatic and gut hormones, as well as satiety, were evaluated at breakfast and lunch. Compared with the CD diet, the CRHP diet reduced postprandial AUC of glucose by 14 %, insulin by 22 % and glucose-dependent insulinotropic polypeptide by 17 % (allP<0·001), respectively. Correspondingly, glucagon AUC increased by 33 % (P<0·001), cholecystokinin by 24 % (P=0·004) and satiety scores by 7 % (P=0·035), respectively. A moderate reduction in carbohydrate with an increase in fat and protein in the diet, compared with an energy-matched CD diet, greatly reduced postprandial glucose excursions and resulted in increased satiety in patients with well-controlled T2DM.

iGlarLixi: A Fixed-Ratio Combination of Insulin Glargine 100 U/mL and Lixisenatide for the Treatment of Type 2 Diabetes

2017 ◽  
Vol 51 (11) ◽  
pp. 990-999 ◽  
Author(s):  
Jennifer Goldman ◽  
Jennifer M. Trujillo
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Glargine ◽  
English Language ◽  
Data Extraction ◽  
Safety Data ◽  
Fixed Ratio ◽  
Postprandial Glucose ◽  
The United States ◽  
Glucagon Like Peptide 1

Objective: To review the safety and efficacy of iGlarLixi, a titratable fixed-ratio combination of insulin glargine 100 U/mL (iGlar) and lixisenatide, a glucagon-like peptide-1 receptor agonist. Data Sources: A literature search of MEDLINE for all English-language primary articles through June 2016, using the terms LixiLan, iGlarLixi and insulin glargine and lixisenatide, and a search of abstracts presented at the 2016 Scientific Sessions of the American Diabetes Association were performed. Study Selection and Data Extraction: All studies assessing the efficacy and/or safety of iGlarLixi were evaluated. Data Synthesis: iGlarLixi has been approved in the United States for glycemic control in people with type 2 diabetes (T2D) inadequately controlled with basal insulin (<60 U/d) or lixisenatide. In clinical trials, iGlarLixi was associated with significantly greater reductions from baseline in glycated hemoglobin A1C (A1C) than iGlar or lixisenatide alone. Reductions in postprandial glucose were also greater with iGlarLixi than with iGlar or lixisenatide. iGlarLixi was weight neutral compared with the weight gain with iGlar and loss with lixisenatide alone, and there was no increase in hypoglycemia with iGlarLixi compared with iGlar despite the greater A1C reduction. Gastrointestinal events, frequently associated with lixisenatide, were less common with iGlarLixi. Potential drawbacks of iGlarLixi include reduced flexibility in dosing and the absence of long-term efficacy and safety data. Conclusions: iGlarLixi is a titratable fixed-ratio combination that shows improved efficacy and comparable or improved safety outcomes relative to its separate constituents, offering an alternative approach to intensification of therapy in T2D.

Co-Purification of Recombinant Modified Glucagon-Like and Glucose-Dependent Insulinotropic Peptide to Create a Two-Component Drug for the Treatment of Type 2 Diabetes Mellitus and Obesity

2021 ◽  
Vol 37 (6) ◽  
pp. 74-83
Author(s):  
A.Yu. Gorbunova ◽  
E.P. Sannikova ◽  
I.I. Gubaidullin ◽  
O.M. Ignatova ◽  
M.Yu. Kopaeva ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Mouse Model ◽  
Specific Activity ◽  
Two Component ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Insulinotropic Peptide

In addition to the previously developed recombinant modified human glucagon-like peptide 1 (rmglp1, Glypin), a recombinant modified human glucose-dependent insulinotropic peptide (RMGIP) has been obtained. A new universal reverse-phase HPLC technique has been proposed allowing quantitative analysis of rmGlp1 and rmGip separately and as part of a two-component preparation. The data show that the design of recombinant human rmGip according to the Glypine formula makes it possible to produce one-component and two-component preparations containing various rmGip and rmGlp1 protein ratios ranging from 1:0 to 20:1, using cell biomass samples mixed in predetermined proportions. Studies of human rmGip activity in a mouse model revealed reduced specific activity and signs of weak antagonistic effects. In this regard, there is a need for further study of human rmGip activity in a mouse model, including the use of alternative mouse or rat rmGip. type 2 diabetes mellitus; two-component drug, glucose-dependent insulinotropic peptide, glucagon-like peptide-1 The work was supported by the Internal Grant from National Research Center Kurchatov Institute.

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