Mixed meal ingestion diminishes glucose excursion in comparison with glucose ingestion via several adaptive mechanisms in people with and without type 2 diabetes

Alsalim, Wathik; Tura, Andrea; Pacini, Giovanni; Omar, Bilal; Bizzotto, Roberto; Mari, Andrea; Åhrén, Bo

doi:10.1111/dom.12570

Cited by 32 publications

(49 citation statements)

References 40 publications

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“…This occurred in association with increased β-cell function, reduced insulin clearance, delayed gastric emptying and augmented glucagon and GIP secretion [12]. These findings may be in line with our observation that post-prandial low glycemia was frequently observed more after meal ingestion (58 g carbohydrates) than after 75 g glucose ingestion in young women.…”

Section: Discussionsupporting

confidence: 88%

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Post-Prandial Plasma Glucose Less Than or Equal to 70 mg/dL Is Not Uncommon in Young Japanese Women

et al. 2017

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BackgroundPost-breakfast/post-challenge plasma glucose (PG) concentrations were studied less in young normal weight Japanese women. We addressed these issues.MethodsTwo separate groups of female collegiate athletes and female untrained students underwent either a standardized meal test or a standard 75-g oral glucose tolerance test, but not both. Frequency of women whose post-breakfast/post-load PG fell to 70 mg/dL or lower (termed as low glycemia) was compared between athletes and non-athletes, who also underwent measurements of serum adipokines, markers of insulin resistance and inflammation and dual-energy X-ray absorptiometry. Insulin secretion, insulin sensitivity/resistance and serum adipokines were compared between women with and without post-breakfast low glycemia. The same comparison was done between women whose post-breakfast PG returned to levels below the fasting PG and women whose post-breakfast PG never fell below the fasting PG.ResultsThere was no difference between athletes and non-athletes in frequency of post-breakfast low glycemia (47% (8/17) and 44% (8/18)) and post-challenge low glycemia (24% (12/50) and 23% (27/118)). As compared to seven women whose post-breakfast PG never fell below the fasting PG, 28 women whose post-breakfast PG returned to levels below the fasting PG had higher meal-induced insulin responses (283 ± 366 vs. 89 ± 36 µU/mg, P = 0.014). However, two groups did not differ in body composition, markers of insulin resistance and serum adiponectin. No significant difference was also observed in any of these variables between women with and without post-breakfast low glycemia.ConclusionPost-prandial PG ≤ 70 mg/dL is not uncommon in young normal weight Japanese women and may not be a pathological condition. The underlying mechanisms for this finding need further exploration.

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Section: Discussionsupporting

confidence: 88%

“…Adding protein and fat macronutrients to glucose in a mixed meal diminished glucose excursion as compared with the same amount of glucose challenge alone [12]. This occurred in association with increased β-cell function, reduced insulin clearance, delayed gastric emptying and augmented glucagon and GIP secretion [12].…”

Section: Discussionmentioning

confidence: 99%

Post-Prandial Plasma Glucose Less Than or Equal to 70 mg/dL Is Not Uncommon in Young Japanese Women

et al. 2017

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“…Our analysis confirmed the results of previous studies, which showed that GLP-1 and GIP secretion are stimulated by all three macronutrients, carbohydrate, protein and fat. [25][26][27][28] Although our study was not designed to test the effects of individual macronutrients on incretin hormone secretion, our data indicate that GIP secretion is dependent on total energy intake and possibly on energy intake by protein and fat, as it was largest after lunch, which had a higher total caloric content and highest caloric provision from protein and fat. In contrast, no such dependency was evident for energy intake by carbohydrate or for GLP-1 secretion.…”

Section: Dpp-4 Inhibition Differs Between Dpp-4 Inhibitors Although mentioning

confidence: 94%

Persistent whole day meal effects of three dipeptidyl peptidase‐4 inhibitors on glycaemia and hormonal responses in metformin‐treated type 2 diabetes

Alsalim

Göransson

Tura

et al. 2019

Diabetes Obesity Metabolism

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Aim Dipeptidyl peptidase‐4 (DPP‐4) inhibition has effects on both fasting and postprandial glucose. However, the extent of this effect over the whole day and whether different DPP‐4 inhibitors have the same effects have not been established. We therefore explored the whole day effects of three different DPP‐4 inhibitors versus placebo on glucose, islet and incretin hormones after ingestion of breakfast, lunch and dinner in subjects with metformin‐treated and well‐controlled type 2 diabetes. Methods The study was single‐centre and crossover designed, involving 24 subjects [12 men, 12 women, mean age 63 years, body mass index 31.0 kg/m2, glycated haemoglobin 44.7 mmol/mol (6.2%)], who underwent four test days in random order. Each whole day test included ingestion of standardized breakfast (525 kcal), lunch (780 kcal) and dinner (560 kcal) after intake of sitagliptin (100 mg) or vildagliptin (50 mg twice), or saxagliptin (5 mg) or placebo. Results Compared with placebo, DPP‐4 inhibition reduced glucose levels, increased beta‐cell function (insulin secretory rate in relation to glucose), suppressed glucagon, increased intact glucagon‐like‐peptide‐1 (GLP‐1) and glucose‐dependent insulinotropic polypeptide (GIP) but suppressed total GLP‐1 and GIP after all three meals. The effects were sustained throughout the daytime period with similar changes after each meal and did not differ between the DPP‐4 inhibitors. Conclusions DPP‐4 inhibition has persistent daytime effects on glucose, islet and incretin hormones with no difference between three different DPP‐4 inhibitors.

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“…GLP-1, mainly secreted by intestinal enteroendocrine L cells in the ileum can inhibit the pancreas islet a cells, thus improving postprandial glycemia and insulin resistance [85]. GIP, mainly secreted by K cells of the duodenum and jejunum, plays an indispensable role in improving postprandial glycemia and insulin resistance with the function of GLP-1 by stimulating the pancreas islet b cells [86]. Intestinal motility is modulated by multiple hormones.…”

Section: Gastrointestinal Motility Adjustmentmentioning

confidence: 99%

Potential mechanisms of sleeve gastrectomy for reducing weight and improving metabolism in patients with obesity

Huang

Ding

et al. 2019

Surgery for Obesity and Related Diseases

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Obesity is a severe medical problem endangering the health of individuals worldwide. Sleeve gastrectomy (SG), one of the most commonly performed bariatric procedures, has been widely applied to the treatment of such patients. Currently, the potential mechanisms underlying the significant weight loss and metabolic improvement after SG have been well studied. First, and most importantly, by removing a large volume of stomach, the SG directly or indirectly restricts food intake. Then, there are alterations in the absorption and metabolism of both macro-and micronutrients, which may benefit or worsen the patients' well-being. Another profound change is enhanced secretion of the satiety gut hormone and reduced secretion of the hunger hormone as a consequence of the operation. Additionally, adjustment of gastrointestinal motility, alteration in the gut microbial community, and an inflammatory response were found after surgery. Therefore, the purpose of the present review was focused on such hypotheses and to compile the accumulated facts on the physiologic mechanism of bariatric surgery so that these results can help improve the understanding of how SG produces substantial weight loss and a significant improvement in the metabolism of patients with metabolic syndrome.

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Mixed meal ingestion diminishes glucose excursion in comparison with glucose ingestion via several adaptive mechanisms in people with and without type 2 diabetes

Cited by 32 publications

References 40 publications

Post-Prandial Plasma Glucose Less Than or Equal to 70 mg/dL Is Not Uncommon in Young Japanese Women

Post-Prandial Plasma Glucose Less Than or Equal to 70 mg/dL Is Not Uncommon in Young Japanese Women

Persistent whole day meal effects of three dipeptidyl peptidase‐4 inhibitors on glycaemia and hormonal responses in metformin‐treated type 2 diabetes

Potential mechanisms of sleeve gastrectomy for reducing weight and improving metabolism in patients with obesity

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