Reduced water intake deteriorates glucose regulation in patients with type 2 diabetes

Johnson, Evan C.; Bardis, Costas N.; Jansen, Lisa T.; Adams, Jennifer; Kirkland, Tracie; Kavouras, Stavros A.

doi:10.1016/j.nutres.2017.05.004

Cited by 44 publications

(46 citation statements)

References 35 publications

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“…Conversely, a detrimental effect of 3 days of water restriction was demonstrated during an experimental study investigating glucose homeostasis in hypohydrated men with type 2 diabetes. In this study, impaired glucose regulation during an oral glucose tolerance test was paralleled by elevated plasma osmolality and cortisol concentrations, suggesting vasopressin-mediated ACTH and cortisol release [49]. In line with this finding, it is known that habitual low drinkers (≤1.2 L water/day) have elevated plasma cortisol concentration when compared to high drinkers (2-4 L water/day) [46].…”

Section: Potential Improvement Of Glucose Metabolism and Cardiometabosupporting

confidence: 81%

The Vasopressin System in the Risk of Diabetes and Cardiorenal Disease, and Hydration as a Potential Lifestyle Intervention

Enhörning¹,

Melander²

2018

Ann Nutr Metab

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Background: Type 2 diabetes, chronic kidney disease (CKD) and its cardiovascular complications are increasing as health problems worldwide. These diseases are interrelated with overlapping occurrence and once diabetes is established, the risk of cardiorenal disease is dramatically elevated. Thus, a search for unifying modifiable risk factors is key for effective prevention. Summary: Elevated fasting plasma concentration of vasopressin, measured with the marker copeptin, predicts new onset type 2 diabetes as well as renal function decline. Furthermore, we recently showed that increased plasma copeptin concentration independently predicts the development of both CKD and other specified kidney diseases. In consequence, high copeptin is an independent risk factor for cardiovascular disease and premature mortality in both diabetes patients and in the general population. Vasopressin is released when plasma osmolality is high, and the easiest way to lower plasma vasopressin and copeptin concentration is to increase water intake. In a human water intervention experiment with 1 week of 3 L/day increased water intake, the one third of the participants with the greatest copeptin reduction (water responders) were those with a phenotype of low water intake (high habitual plasma copeptin and urine osmolality, and low urine volume). The water-responders had a copeptin reduction of 41% after 1 week of increased water intake compared to a control week; in contrast, a 3% reduction occurred in the other two thirds of the study participants. Among water responders, increased water intake also induced a reduction in fasting glucagon concentration. Key Messages: Elevated copeptin, a measure of vasopressin, is a risk marker of metabolic and cardiorenal diseases and may assist in the detection of individuals at higher risk for these diseases. Furthermore, individuals with high copeptin and other signs of low water intake may experience beneficial glucometabolic effects of increased water intake. Future randomized control trials investigating effects of hydration on glucometabolic and renal outcomes should focus on individuals with signs of low water intake including high plasma copeptin concentration.

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Section: Potential Improvement Of Glucose Metabolism and Cardiometabosupporting

confidence: 81%

The Vasopressin System in the Risk of Diabetes and Cardiorenal Disease, and Hydration as a Potential Lifestyle Intervention

Enhörning¹,

Melander²

2018

Ann Nutr Metab

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“…If favorable changes in these hormones can be achieved by preventing fluid losses in total body water, this could reduce the need for alternative, expensive strategies for glycemic control such as medications, and could be included with dietary and physical activity recommendations for proper blood glucose management. There remains uncertainty regarding the role of hydration on glucose regulation [19,28,29,99,100] and the precise mechanism by which this occurs. Specifically, the differential responses observed in populations with diabetes versus those without diabetes may have been due to the glucosuria observed in individuals with diabetes who went off of their medication for the study [100].…”

Section: Glycemic Regulationmentioning

confidence: 99%

“…Recent evidence has suggested a link between body water deficits and impairments in blood glucose regulation, particularly in individuals with type 2 diabetics, attributed to elevations in the fluid regulatory hormone arginine vasopressin (AVP) [ 19 , 21 , 28 , 29 , 30 ]. Centrally, AVP binds to V1b receptors in the anterior pituitary gland [ 31 ] and through the secretion of cortisol, via the AVP-mediated activation of adrenocorticotropic hormone (ACTH), increases hepatic glucose output [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Acute Hypohydration on Indicators of Glycemic Regulation, Appetite, Metabolism and Stress: A Systematic Review and Meta-Analysis

Zaplatosch

Adams

2020

Nutrients

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Evidence synthesizing the effects of acute body water losses on various markers of glycemic regulation, appetite, metabolism, and stress is lacking. Thus, the purpose of this review was to summarize the response of various hormonal changes involved in these physiologic functions to dehydration. A comprehensive literature search for peer-reviewed research in the databases PubMed, Scopus, CINAHL, and SportDiscus was conducted. Studies were included if they contained samples of adults (>18 years) and experimentally induced dehydration as measured by acute body mass loss. Twenty-one articles were eligible for inclusion. Findings suggested cortisol is significantly elevated with hypohydration (standard mean difference [SMD] = 1.12, 95% CI [0.583, 1.67], p < 0.0001). Testosterone was significantly lower in studies where hypohydration was accompanied by caloric restriction (SMD= −1.04, 95% CI [−1.93, −0.14], p = 0.02), however, there were no changes in testosterone in studies examining hypohydration alone (SMD = −0.17, 95% CI [−0.51 0.16], p = 0.30). Insulin and ghrelin were unaffected by acute total body water losses. Acute hypohydration increases markers of catabolism but has a negligible effect on markers of glycemic regulation, appetite, anabolism and stress. Given the brevity of existing research, further research is needed to determine the impact of hydration on glucagon, leptin, peptide YY and the subsequent outcomes relevant to both health and performance.

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“…In general, dehydration may affect the rate of glucose oxidation and glycogen metabolism, increasing carbohydrate needs and potentially increasing the risk of hypoglycaemia [24-27] in individuals with type 1 diabetes. Moreover, low total water intake in people with T2DM acutely impairs blood glucose response during an oral glucose tolerance test [28]. Suboptimal fluid intake is a known risk factor for several diseases, due to increased vasopressin concentration stimulating SGK1 expression, and fostering the development of hypertension, obesity, diabetes, thrombosis, stroke, inflammation, renal failure and tumor growth [29].…”

Section: Discussionmentioning

confidence: 99%

Fluid Intake Habits in Type 1 Diabetes Individuals during Typical Training Bouts

et al. 2018

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Background/Aims: Hyperglycemia may influence the hydration status in diabetic individuals. During exercise, type 1 diabetes mellitus (T1DM) individuals may be challenged by a higher risk of dehydration due to a combination of fluid losses from sweat and increased urine output via glycosuria. So far, no study has characterised spontaneous fluid intake in T1DM individuals during active trainings. Methods: A validated questionnaire was used to assess T1DM participants’ diabetes therapy, sports characteristics and fluid intake during training; results were then compared to an age- and sport-matched sample of non-diabetic individuals. Results: Ninety individuals completed the survey (n = 45 T1DM individuals, n = 45 matched controls). A proportion of T1DM individuals reported blood glucose levels greater than 10.0 mmol at both the start (28.9%) and end (24.4%) of the exercise. The mean self-reported fluid intake was greater in T1DM (0.60 ± 0.47 L·h^–1) compared to that of the control (0.37 ± 0.28 L·h^–1, p < 0.05). In spite of drinking fluid volumes in line with international guidelines, 84.4% of those with T1DM reported that they were still feeling thirsty at the end of their training session. Conclusions: T1DM individuals self-report spontaneously consuming fluid adequate volumes suggested by sport nutrition guidelines for non-diabetic athletes. Discrepancies in the T1DM subjectively reported feelings of thirst suggest that more education on hydration during exercise is needed for this population to adequately compensate for elevated blood glucose levels. It remains to be established whether fluid volumes suggested for healthy athletes are adequate for maintaining euhydration in T1DM patients due to their altered diuresis.

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Reduced water intake deteriorates glucose regulation in patients with type 2 diabetes

Cited by 44 publications

References 35 publications

The Vasopressin System in the Risk of Diabetes and Cardiorenal Disease, and Hydration as a Potential Lifestyle Intervention

The Vasopressin System in the Risk of Diabetes and Cardiorenal Disease, and Hydration as a Potential Lifestyle Intervention

The Effect of Acute Hypohydration on Indicators of Glycemic Regulation, Appetite, Metabolism and Stress: A Systematic Review and Meta-Analysis

Fluid Intake Habits in Type 1 Diabetes Individuals during Typical Training Bouts

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