• Title/Summary/Keyword: Insulin Response

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Changes in the glucose and insulin responses according to high-protein snacks for diabetic patients

  • Yang, Junyoung;Park, Hae Jin;Hwang, Wonsun;Kim, Tae Ho;Kim, Hyeonmok;Oh, Jieun;Cho, Mi Sook
    • Nutrition Research and Practice
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    • v.15 no.1
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    • pp.54-65
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    • 2021
  • BACKGROUND/OBJECTIVES: This study aimed to develop healthy, appetizing high-protein snacks with enhanced isolated soy protein for diabetic patients and determine the blood glucose and insulin response after being consumed by these patients. MATERIALS/METHODS: Thirty adult patients aged between 30 and 75 years, with a ≤ 10-year history of type 2 diabetes and hemoglobin A1c of < 7.5%, were enrolled in this study. They made 3 clinical visits at one-week intervals. The control group consumed 50 g carbohydrates (white bread), whereas the test groups consumed high-protein grain (HP_G) or high-protein chocolate (HP_C) after an 8-hrs fast. Blood (2 ㎤) was drawn at 15, 30, 45, 60, 90, and 120 min before and after consumption to analyze the blood glucose and insulin concentrations. RESULTS: Compared to the commercial snacks, the developed high-protein snacks had below-average calorie, carbohydrate, and fat content and a 2.5-fold higher protein content. In diabetic patients who consumed these snacks, the postprandial blood glucose increased between 15 min and 2 h after consumption, which was significantly slower than the time taken for the blood glucose to increase in the patients who consumed the control food product (P < 0.001). Insulin secretion was significantly lower at 45 min after consumption (P < 0.05), showing that the high-protein snacks did not increase the blood glucose levels rapidly. The incremental area under the curve (iAUC), which indicated the degree of blood sugar and insulin elevation after food intake, was higher in the control group than the groups given the 2 developed snacks (P < 0.001), and there was no significant difference in insulin secretion. CONCLUSIONS: The results of the postprandial blood glucose and insulin response suggest that high-protein snacks are potential convenient sources of high-quality protein and serve as a healthier alternative for patients with type 2 diabetes, who may have limited snack product choices. Such snacks may also provide balanced nutrition to pre-diabetic and obese individuals.

A Study of the Insulin and the C-Peptide Responses to Oral Glucose Load in Nondiabetic and Diabetic Subjects (정상인(正常人) 및 당뇨병환자(糖尿病患者)에서의 경구당부하시(經口糖負荷時) 혈중(血中) Insulin과 C-Peptide의 변동(變動))

  • Lee, Myung-Chul;Choi, Sung-Jae;Kim, Eung-Jin;Min, Hun-Ki;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.11 no.1
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    • pp.17-32
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    • 1977
  • The present study was undertaken to evaluate the significance of the insulin and the C-peptide rseponse to oral glucose loads in normal and diabetic subjects and to establish the effects of the obesity. In this study, the authors have measured plasma insulin and C-peptide by means of radioimmunoassay in 10 nonobese normal, 5 obese normal, 13 nonobese moderate diabetic patients, 9 obese moderate diabetic patients and 9 severe diabetic patients. The results obtained were as follows; 1. In 10 nonobese normal subjects, the plasma insulin level at fasting state and at 30, 60, 90, and 120 min after oral glucose loads were $15.7{\pm}3.4,\;48.3{\pm}9.8,\;40.4{\pm}6.7,\;37.4{\pm}6.5\;and\;26.0{\pm}4.2uU/ml(Mean{\pm}S.E.)$ and C-peptide were $1.9{\pm}0.3,\;3.9{\pm}0.6,\;6.3{\pm}0.6,\;5.7{\pm}0.5\;and\;4.0{\pm}0.5ng/ml$. The change of C-peptide was found to go almost parallel with that of insulin and the insulin value reaches to the highest level at 30 min whereas C-peptide reaches to its peak at 60min. 2. The plasma insulin level in 5 obese normal subjects were $38.9{\pm}12.3,\;59.5{\pm}12.3,\;59.2{\pm}17.1,\;56.1{\pm}20.0\;and\;48.4{\pm}17.2uU/ml$ and the C-peptide were $5.5{\pm}0.4,\;6.8{\pm}0.5,\;7.9{\pm}0.8,\;7.9{\pm}0.8\;and\;7.8{\pm}2.0ng/ml$. The insulin response appeared to be greater than nonobese normal subjects. 3. In 13 nonobese moderate diabetic patients, the plasma insulin levels were $27.1{\pm}4.9,\;44.1{\pm}6.0,\;37.3{\pm}6.6,\;35.5{\pm}8.1\;and\;34.7{\pm}10.7uU/ml$ and the C-peptide levels were $2.7{\pm}0.4,\;4.9{\pm}0.7,\;6.5{\pm}0.5,\;7.0{\pm}0.3\;and\;6.7{\pm}1.0ng/ml$. There was little significance compared to nonobese normal groups but delayed pattern is noted. 4. In 9 obese moderated diabetic patients, the plasma insulin levels were $22.1{\pm}7.9,\;80.0{\pm}19.3,\;108.0{\pm}27.0,\;62.0{\pm}17.6\;and\;55.5{\pm}10.1uU/ml$ and the C-peptide levels were $5.2{\pm}0.4,\;8.0{\pm}1.0,\;10.4{\pm}1.6,\;10.4{\pm}1.7\;and\;10.1{\pm}1.0ng/ml$ and its response was also greater than that of nonobese moderate diabetic patients. 5. The plasma insulin concentrations in 9 severe diabetic subjects were $8.0{\pm}3.8,\;12.1{\pm}3.5,\;16.8{\pm}4.6,\;19.6{\pm}5.2\;and\;15.0{\pm}5.0uU/ml$ and the C-peptide levels were $1.6{\pm}0.3,\;2.4{\pm}0.4,\;4.1{\pm}0.6,\;4.0{\pm}0.8\;and\;4.5{\pm}0.7ng/ml$ and the insulin and C-peptide responses were markedly reduced in severe diabetic groups. 6. There were-significant differences between each groups of patients on the magnitude of total insulin or C-peptide areas, the insulinogenic index and the C-peptide index.

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Influence of Dietary Salinomycin on Feeding-induced Variations of Glucose Kinetics and Blood Volatile Fatty Acids and Insulin Concentrations in Sheep Fed a High-roughage Diet

  • Fujita, Tadahisa;Itoh, Takahiro;Majima, Hiroya;Sano, Hiroaki
    • Asian-Australasian Journal of Animal Sciences
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    • v.20 no.3
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    • pp.365-372
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    • 2007
  • This study was conducted to determine effects of salinomycin (SL) on feeding-induced changes in glucose kinetics and blood VFA concentrations in sheep fed a high-roughage diet. Four sheep were fed the diet with or without 20 mg/kg diet of SL once daily for 21 d. Glucose entry and utilization rates were determined during the prefeeding and 3 h postfeeding periods, using a [$^{13}C_6$]glucose dilution method and non-steady state equations. Ruminal characteristics and concentrations of blood VFA, plasma glucose and insulin were also measured during the same periods. A feeding-induced increase in ruminal total VFA concentration tended to be inhibited (p<0.10) with SL, although ruminal pH was unaffected (p>0.10) with SL or by feeding. Salinomycin decreased (p<0.05) acetate proportion and increased (p<0.05) propionate proportion in the rumen, but did not modify these changes in response to feeding (p>0.10). A feeding-induced increase in blood acetate concentration was attenuated (p<0.05) with SL. Salinomycin tended to increase (p<0.10) blood propionate concentration without modifying its response patterns to feeding (p>0.10). Plasma concentrations of glucose or insulin were unaffected (p>0.10) with SL. Salinomycin tended to enhance (p<0.10) glucose entry and utilization rates. Feeding also enhanced (p<0.01) both rates, whereas their interactive effect was not detected (p>0.10). We conclude that SL possibly enhances whole body glucose entry and utilization with an increase in blood propionate concentration in sheep given a high-roughage diet, although SL does not appear to affect their responses to feeding.

C/EBP$\beta$ and Nrf2-Mediated GSTA2 Induction by $\alpha$-Lipoic acid, an Insulin-Sensitizing Agent that has Antioxidant and Prooxidant Activities

  • Ki, Sung-Hwan;Cho, Il-Je;Kim, Sang-Geon
    • Proceedings of the PSK Conference
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    • 2003.10b
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    • pp.82.1-82.1
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    • 2003
  • The protective adaptive response to electrophiles and reactive oxygen species is mediated by enhanced expression of phase II detoxifying genes including glutathione S-transferases. ${\alpha}$-Lipoic acid, which exerts prooxidant or antioxidant activities, has been shown to activate the insulin signaling pathway and thus to induce insulin-like actions via PI3-kinase and Akt. Our previous studies have shown that PI3-kinase plays an essential role in Nrf2-or C/EBP${\beta}$-mediated glutathione S-transferase A2 (GSTA2) induction. (omitted)

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Glucose and Insulin Stimulate Lipogenesis in Porcine Adipocytes: Dissimilar and Identical Regulation Pathway for Key Transcription Factors

  • Zhang, Guo Hua;Lu, Jian Xiong;Chen, Yan;Dai, Hong Wei;ZhaXi, YingPai;Zhao, Yong Qing;Qiao, Zi Lin;Feng, Ruo Fei;Wang, Ya Ling;Ma, Zhong Ren
    • Molecules and Cells
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    • v.39 no.11
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    • pp.797-806
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    • 2016
  • Lipogenesis is under the concerted action of ChREBP, SREBP-1c and other transcription factors in response to glucose and insulin. The isolated porcine preadipocytes were differentiated into mature adipocytes to investigate the roles and interrelation of these transcription factors in the context of glucose- and insulin-induced lipogenesis in pigs. In ChREBP-silenced adipocytes, glucose-induced lipogenesis decreased by ~70%, however insulin-induced lipogenesis was unaffected. Moreover, insulin had no effect on ChREBP expression of unperturbed adipocytes irrespective of glucose concentration, suggesting ChREBP mediate glucose-induced lipogenesis. Insulin stimulated SREBP-1c expression and when SREBP-1c activation was blocked, and the insulin-induced lipogenesis decreased by ~55%, suggesting SREBP-1c is a key transcription factor mediating insulin-induced lipogenesis. $LXR{\alpha}$ activation promoted lipogenesis and lipogenic genes expression. In ChREBP-silenced or SREBP-1c activation blocked adipocytes, $LXR{\alpha}$ activation facilitated lipogenesis and SREBP-1c expression, but had no effect on ChREBP expression. Therefore, $LXR{\alpha}$ might mediate lipogenesis via SREBP-1c rather than ChREBP. When ChREBP expression was silenced and SREBP-1c activation blocked simultaneously, glucose and insulin were still able to stimulated lipogenesis and lipogenic genes expression, and $LXR{\alpha}$ activation enhanced these effects, suggesting $LXR{\alpha}$ mediated directly glucose- and insulin-induced lipogenesis. In summary, glucose and insulin stimulated lipogenesis through both dissimilar and identical regulation pathway in porcine adipocytes.

Effect of Glucose and Insulin on Human Gingival Fibroblasts and Periodontal Ligament Cells (포도당 및 인슐린이 인체 치은섬유모세포와 치주인대세포에 미치는 영향)

  • Han, Hee-Ran;Kim, Eung-Tea;You, Hyung-Keun;Shin, Hyung-Shik
    • Journal of Periodontal and Implant Science
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    • v.28 no.1
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    • pp.133-143
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    • 1998
  • Diabetes mellitus is a systemic disease with profound effects on oral health and periodontal wound healing. Uncontrolled diabetes adversely affects surgical wound healing and is often associated with abnormal proliferation of fibroblasts. Human gingival fibroblasts and PDL cells were chosen because they are intimately involved in periodontal therapy and are important for the success of surgical procedure such as guided tissue regeneration. The aim of the present study was to elucidate whether cellular activity and collagen synthesis by glucose pre-treated human gingival fibroblasts and PDL cells are influenced by insulin, and whether healthy cells differ from glucose treated cells. Cells were cultured with DMEM at $37^{\circ}C$, 5% $CO_2$, 100% humidified incubator. To evaluate the effect of glucose on gingival fibroblasts and periodontal ligament cells, the cells were seeded at a cell density of $1{\times}10^4\;cells/well$ culture plates and treated with 20 and 50mM of glucose for 5 days. Then MTT assay was carried out. To evaluate the effect of insulin on glucose-pretreated cells, the cells were seeded at a cell density of $1{\times}10^4\;cells/well$ culture plates and treated with 20 and 50mM of glucose for 5 days. After incubation, $10^3$, $10^4$ and $10^5mU/l$ of insulin were also added to the each well and incubated for 2 days, respectively. Then, MTT assay and collagen synthesis assay were carried out. The results indicate that cellular activity of gingival fibroblasts significantly increased by glucose while periodontal ligament cells were unaffected and cellular activity of gingival fibroblasts and periodontal ligament cells were unaffected by insulin. Collagen synthesis of gingival fibroblast with 20mM glucose and insulin unaffected, but 50mM glucose and insulin increased than control. Collagen synthesis of periodontal ligament cell with 20mM glucose and $10^5mU/l$ insulin significantly increased than other groups and 50mM glucose pretreated PDL cells significantly increased at $10^3mU/l$ insulin but decreased at $10^4mU/l$ insulin. Our findings indicated that these cell types differed in their growth response to glucose, and the increase in collagen synthesis was significantly raised at insulin level of $10^3mU/l$ in gingival fibroblasts and periodontal ligament cells except 20mM glucose pretreated periodontal ligament cells.

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The Effect of Metformin in Non-Obese Women with Polycystic Ovary Syndrome; Pilot Study (비만하지 않은 다낭성난소증후군 환자에서 메트포민 효용성의 예비 연구)

  • Kim, Hyeong-Ok;Kim, Kye-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.3
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    • pp.223-229
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    • 2008
  • Objective: This pilot study was performed to investigate the effect of metformin on insulin resistance, hormone levels, and lipid profiles in non-obese patients with polycystic ovary syndrome. Methods: This study included 16 non-obese patients with polycystic ovary syndrome diagnosed at our hospital from June 2006 to September 2007. Blood samples were collected before and 6 months after metformin treatment for analysis of fasting serum glucose levels, fasting serum insulin levels, a glycemic response to 75 g oral glucose tolerance test (OGTT), and hormonal blood profile including FSH, LH, estradiol, testosterone, free testosterone, serum lipid profiles. Insulin resistance was estimated by calculating fasting glucose/insulin ratio (FGIR), 2 hr glucose/insulin ratio after 75 g glucose load. And we investigated insulin resistance and pancreatic beta cell function by calculating HOMA beta cell function and HOMA IR. Results: After the treatment of metformin, there was significant increase in 2 hr glucose/insulin ratio after 75 g glucose load (p=0.04) and decrease in HOMA IR (p=0.000). But serum lipid profiles did not change significantly. Also the metformin treatment induced a significant reduction in serum free testosterone and LH levels, and LH/FSH ratio (p=0.001, p=0.000, p=0.034). Conclusion: This pilot study showed that metformin might be effective in improving insulin sensitivity, ameliorating hyperandrogenemia in non-obese patients with polycystic ovary syndrome. Further investigations with larger number of patients and long-term observations are necessary to determine the role of metformin.

Molecular Events of Insulin Action Occur at Lipid Raft/Caveolae in Adipocytes (지방세포의 Lipid Raft/Caveolae에서 인슐린의 분자적 작용기전)

  • Bae, Sun-Sik;Yun, Sung-Ji;Kim, Eun-Kyung;Kim, Chi-Dae;Choi, Jang-Hyun;Suh, Pann-Ghill
    • Journal of Life Science
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    • v.17 no.1 s.81
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    • pp.56-63
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    • 2007
  • Insulin stimulates the fusion of intracellular vesicles containing glucose transporter 4 (GLUT4) with plasma membrane in adipocytes and muscle cells. Here we show that adipocyte differentiation results in enhanced insulin sensitivity of glucose uptake. On the other hand, glucose uptake in response to platelet-derived growth factor (PDGF) stimulation was markedly reduced by adipocyte differentiation. Expression level of insulin receptor and caveolin-1 was dramatically increased during adipocyte differentiation. Adipocyte differentiation caused :ilightly enhanced activation of acutely transforming retrovirus AKT8 in rodent T cell lymphoma (Akt) by insulin stimulation. However, activation of Akt by PDGF stimulation was largely reduced. Activation of ERK was not detected in both fibroblasts and adipocytes after stimulation with insulin. PDGF-dependent activation of ERK was reduced by adipocyte differentiation. Insulin-dependent glucose uptake was abrogated by LY294002, a phosphatidylinositol 3-kinase (PI3K) inhibitor, in both fibroblasts and adipocytes. Also disassembly of caveolae structure by $methyl-\beta-cyclodextrin$ caused impairment of Akt activation and glucose uptake. Finally, insulin receptor, Akt, SH2-domain-containing inositol 5-phosphatase 2 (SHIP2), and regulatory subunit of PI3K are localized at lipid raft domain and the translocation was facilitated upon insulin stimulation. Given these results, we suggest that lipid raft provide proper site for insulin action for glucose uptake.

The Effect of Enteral Nutrition Formula Supplement on Body Weight of Nonobese NIDDM Patients (비비만형 인슐린 비의존형 당뇨병 환자에서 영양음료를 사용한 체중 증가의 효과)

  • 이종호
    • Journal of Nutrition and Health
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    • v.27 no.10
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    • pp.1048-1057
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    • 1994
  • Nonobese NIDDM patients were studied were studied with respect to changes in visceral protein status, serum glucose and lipids and insulin secretion capacity before and after intake of enteral formula. Patients with renal or hepatic disease, gastrectomy, malabsorption, weight gain over past 6 months and poorly controlled blood glucose level were excluded. Eighteen patients served as case and administered, in addition of their usual diet, 400ml of enteral formula for 8 weeks. Another 18 patients participated in controls and had usual food intake for 8 weeks. In the begining, the levels of fasting and postprandial glucose, glycated hemoglobin, triglyceride, HDL, LDL, total cholesterol, albumin, total protein and transferrin and glucose response area on oral glucose tolerance test were not different between two groups. The response areas of insulin, C-peptide and free fatty acid and serum IGF-1 level were higher in the case than in the control group. Energy intake of patients given enteral formula exceeded their estimated energy requirements(108%) and they consumed a mean of 112g protein per day. Patients given enteral formula showed an increase in body weight(4.4%), serum transferrin(10%), IGF-1(13%) and triglyceride(34%) while controls showed no changes in those parameters at 8 weeks compared to initial values. There were no significant changes after 8 weeks in the levels of glucose, glycated hemoglobin, HDL, LDL, total cholesterol, total protein and albumin and response areas of glucose, insulin, C-peptide and free fatty acid in both groups compared to initial values. This study suggests that nutrition supplement with enteral formula can increase body weight and visceral protein status in nonobese NIDDM patients without changes in blood glucose. However, excessive calorie intake could temporarily increase serum triglyceride. In addition, this study indicates that serum transferrin and IGF-1 are more sensitive indicators to changes of protein intake than serum albumin and total protein.

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Effect of Enteral Nutrition Supplementation on Glucose Metabolism in patients with NIDDM (인슐린 비의존형 당뇨병 환자에서 영양음료 섭취가 혈청 당질에 미치는 영향)

  • 김희선
    • Journal of Nutrition and Health
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    • v.27 no.8
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    • pp.805-818
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    • 1994
  • This study investigated the effect of enteral nutrition supplementation on glucose and lipid metabolism in non-insulin dependent diabetes mellitus(NIDDM) patients(n=29). Nutrition formula(400kcal/day) were supplied daily for eight weeks as a substitute for a snack or a meal. Subjects were divided into three groups based on changes of fasting blood glucose(FBG), glucose response area(GRA) on oral glucose tolerance test(OGTT), before and after intake of nutrition formula : group 1(the group of a decrease in FBG and GRA, n=20), group 2(the group of a decrease in FBG and an increase in GRA, n=4), and group 3(the group of an increase in FBF and GRA, n=5). Before nutrition supplementation, group 3 showed a longer tendency of DM duration and a lower tendency of insulin and C-peptide response are than those of group 1 and 2. At 8 weeks after nutrition supplementation, group 1 showed a significant increase in insulin and C-peptide response areas but group 2 and 3 showed no change in those areas. After nutrition supplementation, all three groups showed a tendency of decrease in glycated hemoglobin and no significant changes in the levels of serum triglycerides, HDL, LDL, total cholesterol, albumin, transferrin, creatinine, GOT and GPT. The results suggest that using an enteral nutrition formula in NIDDM patients is a good substitute for a meal or snack and could improve blood glucose control without any changes in lipid levels, and liver and kidney functions. The beneficial effect of nutrition supplementation on glycemic control resulted from components of nutrition formula had such as additional fiber and high monounsaturated fatty acid as the source of fat to be helpful 세 glycemic control in diabetics.

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