Postprandial insulin assay as the earliest biomarker for diagnosing pre-diabetes, type 2 diabetes and increased cardiovascular risk

DiNicolantonio, James J.; Bhutani, Jaikrit; O’Keefe, James H.; Crofts, Catherine

doi:10.1136/openhrt-2017-000656

Cited by 35 publications

(41 citation statements)

References 15 publications

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“…The shape of the insulin curve in the LCHF athletes is similar to that of Kraft pattern IIA and Hayashi pattern 3 (peak insulin at 60 min), which is associated with an increased risk of developing T2D (DiNicolantonio et al, 2017). However, the magnitude of the insulin peak in the LCHF athletes (at ∼45 μU/ml) best resembles Kraft pattern 1, which is associated with normal health (DiNicolantonio et al, 2017). Although within the healthy ranges, the relative reduced glucose tolerance and the inferior insulin profile of the LCHF group would typically be considered clinically relevant.…”

Section: Discussionmentioning

confidence: 98%

Reduced Glucose Tolerance and Skeletal Muscle GLUT4 and IRS1 Content in Cyclists Habituated to a Long-Term Low-Carbohydrate, High-Fat Diet

Webster

Boom

Armino

et al. 2020

International Journal of Sport Nutrition and Exercise Metabolism

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Very little is known about how long-term (>6 months) adaptation to a low-carbohydrate, high-fat (LCHF) diet affects insulin signaling in healthy, well-trained individuals. This study compared glucose tolerance; skeletal muscle glucose transporter 4 (GLUT4) and insulin receptor substrate 1 (IRS1) content; and muscle enzyme activities representative of the main energy pathways (3-hydroxyacetyl-CoA dehydrogenase, creatine kinase, citrate synthase, lactate dehydrogenase, phosphofructokinase, phosphorylase) in trained cyclists who followed either a long-term LCHF or a mixed-macronutrient (Mixed) diet. On separate days, a 2-hr oral glucose tolerance test was conducted, and muscle samples were obtained from the vastus lateralis of fasted participants. The LCHF group had reduced glucose tolerance compared with the Mixed group, as plasma glucose concentrations were significantly higher throughout the oral glucose tolerance test and serum insulin concentrations peaked later (LCHF, 60 min; Mixed, 30 min). Whole-body insulin sensitivity was not statistically significantly different between groups (Matsuda index: LCHF, 8.7 ± 3.4 vs. Mixed, 12.9 ± 4.6; p = .08). GLUT4 (LCHF: 1.13 ± 0.24; Mixed: 1.44 ± 0.16; p = .026) and IRS1 (LCHF: 0.25 ± 0.13; Mixed: 0.46 ± 0.09; p = .016) protein content was lower in LCHF muscle, but enzyme activities were not different. We conclude that well-trained cyclists habituated to an LCHF diet had reduced glucose tolerance compared with matched controls on a mixed diet. Lower skeletal muscle GLUT4 and IRS1 contents may partially explain this finding. This could possibly reflect an adaptation to reduced habitual glucose availability rather than the development of a pathological insulin resistance.

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Section: Discussionmentioning

confidence: 98%

Reduced Glucose Tolerance and Skeletal Muscle GLUT4 and IRS1 Content in Cyclists Habituated to a Long-Term Low-Carbohydrate, High-Fat Diet

Webster

Boom

Armino

et al. 2020

International Journal of Sport Nutrition and Exercise Metabolism

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“…The present study provides novel evidence that waist circumference, physical fitness and HOMA-IR are key predictors of this postprandial insulinaemic response in adolescents. These novel findings provide further evidence that more consideration should be given to the assessment of postprandial insulinaemia, alongside glycaemia, as a risk factor for metabolic health (5)(6)(7) , which highlights the utility of this marker for future research.…”

Section: Discussionmentioning

confidence: 77%

“…Indeed, it might be more appropriate to study the relationships examined in the present study in populations with increased prevalence of risk factors for cardiometabolic diseases, given that they would be the target of future interventions. Nonetheless, identifying these relationships in healthy adolescents provides important information, given the role of postprandial hyperinsulinaemia in the pathophysiology of insulin resistance and related cardiometabolic health issues (5) and suggested early manifestation of such conditions (4) .…”

Section: Discussionmentioning

confidence: 99%

“…Traditionally, fasting glucose and insulin concentrations are commonly used in models of insulin resistance, the most common being the homoeostatic model assessment of insulin resistance (HOMA-IR) (2) . However, it has been argued that the use of such measures do not appropriately screen for related conditions, like type 2 diabetes (5)(6)(7) . Furthermore, HOMA-IR typically reflects hepatic insulin sensitivity and does not account for peripheral insulin sensitivity (16,17) .…”

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confidence: 99%

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Predictors of postprandial glycaemia, insulinaemia and insulin resistance in adolescents

et al. 2020

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Postprandial glycaemia and insulinaemia are important risk factors for type 2 diabetes. The prevalence of insulin resistance in adolescents is increasing, but it is unknown how adolescent participant characteristics such as BMI, waist circumference, fitness and maturity offset may explain responses to a standard meal. The aim of the present study was to examine how such participant characteristics affect the postprandial glycaemic and insulinaemic responses to an ecologically valid mixed meal. Data from the control trials of three separate randomised, crossover experiments were pooled, resulting in a total of 108 participants (52 boys, 56 girls; age: 12.5±0.6 y; BMI: 19.05±2.66 kg·m-2). A fasting blood sample was taken for the calculation of fasting insulin resistance, using the HOMA-IR model. Further capillary blood samples were taken before and 30-, 60- and 120-min after a standardised lunch, providing 1.5 g.kg-1 body mass of carbohydrate, for the quantification of blood glucose and plasma insulin total area under the curve (tAUC). Hierarchical multiple linear regression demonstrated significant predictors for plasma insulin tAUC were waist circumference, physical fitness and HOMA-IR (F(3, 98)=36.78, p<.001, Adj. R 2 =.515). The variance in blood glucose tAUC was not significantly explained by the predictors used (F(7, 94)=1.44, p=.198). Significant predictors for HOMA-IR were BMI and maturity offset (F(2, 102)=14.06, p<.001, Adj. R 2 =.021). In summary, the key findings of the study are that waist circumference, followed by physical fitness, best explained the insulinemic response to an ecologically valid standardised meal in adolescents. This has important behavioural consequences because these variables can be modified.

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“…Participants were healthy of a normal weight and overweight with a BMI ranging from 19.7 to 29 kg/m 2 and having a mean age of 22.9 ± 3.00 years. Participants appeared to have a mean fasting blood glucose below 100 mg/dL and mean insulin level below 30 μU/mL, considered to be in the normal ranges [ 27 , 28 ]. Mean TG level (55.46 ± 17.29 mg/dL) was within the optimal range [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

Impact of Pre-Processed Chickpea Flour Incorporation into “Mankoushe” on Appetite Hormones and Scores

Dandachy

Mawlawi

Chedid

et al. 2018

Foods

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Recently, there has been an increasing interest in integrating pulse flours into pastries and baked products to improve their nutritional and health benefits. “Mankoushe,” a popular Lebanese pastry made up of refined wheat flour was enriched with chickpea flour that is of better nutritional value, and its postprandial glycemia, insulinemia, lipidemia and appetite measures were monitored. A randomized cross-over study was performed on sixteen healthy Lebanese females, age (years): 22.90 ± 3.00, and BMI (kg/m2): 22.70 ± 2.65. Over-night fasted females were asked to consume two iso-energetic meals (201 g; 681 kcal) on two separate days, three days apart. One meal was the “Regular Mankoushe” (RM) made with white flour 100%, and the second meal was the “Chickpeas Mankoushe” (CM) made with a mixture of wheat/chickpea flour (70/30). Blood samples were collected 15 min before meal ingest and at 30, 90, 150 and 210 min postprandial. Glucose, insulin, triglycerides (TG), ghrelin, and glucagon-like peptide 1 (GLP-1) plasma levels were measured. Subjective appetite rating and food intake were also assessed. Incorporation of pre-processed chickpea flour into “Mankoushe” as 30% of the dough was associated with a modest reduction in both glucose and insulin levels, and TG was minimally affected. At the level of appetite hormones, changes in GLP-1 were similar, whereas the reduction in ghrelin was significantly lower after the RM meal and thus favored a higher satiating effect compared to CM. This was not paralleled by a similar change in subjective appetite scores and subsequent energy intake. In conclusion, findings suggest that pre-processed chickpea flour could be a promising functional ingredient of traditional pastries to improve their nutritional quality. Nevertheless, further investigations are warranted regarding its satiating effect.

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Postprandial insulin assay as the earliest biomarker for diagnosing pre-diabetes, type 2 diabetes and increased cardiovascular risk

Cited by 35 publications

References 15 publications

Reduced Glucose Tolerance and Skeletal Muscle GLUT4 and IRS1 Content in Cyclists Habituated to a Long-Term Low-Carbohydrate, High-Fat Diet

Reduced Glucose Tolerance and Skeletal Muscle GLUT4 and IRS1 Content in Cyclists Habituated to a Long-Term Low-Carbohydrate, High-Fat Diet

Predictors of postprandial glycaemia, insulinaemia and insulin resistance in adolescents

Impact of Pre-Processed Chickpea Flour Incorporation into “Mankoushe” on Appetite Hormones and Scores

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