A three-day insulin-induced normoglycemia improves carbohydrate oxidation in type 2 diabetic subjects.
Two months of a better glycemic control improve carbohydrate oxidation in type 2 diabetes. However, this benefit is uncertain for a shorter duration. We tested the effect of 3 days of normoglycemia induced by an insulin infusion. Ten type 2 diabetic subjects (body mass index [BMI], 30.0 +/- 1.1; glycosylated hemoglobin [HbA(1C)], 10.1 +/- 0.5) were studied twice, before and after normal glucose levels were maintained by a 72-hour intravenous insulin infusion. Indirect calorimetry was performed 1 hour before (basal) and during the 3 hours after (postprandial) the ingestion of a standard meal (carbohydrates, 72 g; fat, 21 g; protein, 32 g), at noon. Carbohydrate storage was calculated as ingested carbohydrate - (postprandial glycosuria + suprabasal postprandial carbohydrate oxidation). After normoglycemia, glucose and triglyceride levels were decreased (basal glucose, 13.8 +/- 1.1 mmol/L to 8.8 +/- 0.5; postprandial, 14.9 +/- 0.9 to 11.0 +/- 0.5; basal triglycerides, 2.2 +/- 0.1 mmol/L to 1.6 +/- 0.2; postprandial, 2.7 +/- 0.2 to 1.9 +/- 0.2; all P <.01), C peptides were unchanged. Glycosuria (before, 0.30 mg/kg/min) was abolished after normoglycemia. Basal carbohydrate, lipid, protein oxidation, and energy production rates were unchanged. Postprandial carbohydrate oxidation was increased after normoglycemia (before, 1.33 +/- 0.38 mg/kg/min; after, 1.77 +/- 0.42; P <.05). Lipid oxidation and plasma free fatty acids (FFA) tended to be more suppressed by the meal after normoglycemia (not significant [NS]). Carbohydrate storage (before, 67,5 +/- 4.6 g; after, 65.7 +/- 3.6; NS) and diet-induced thermogenesis did not change after normoglycemia. Short-term insulin-induced normoglycemia improves the postprandial oxidation of carbohydrates, but not their storage.
Rigalleau
Vincent
V
Service de Nutrition et Diabétologie, Hopital Haut-Lévêque, Pessac, France.
Rabemanantsoa
Christian
C
Gin
Henri
H
D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism*; D004040:Dietary Carbohydrates / Q000378:metabolism*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage*; D015227:Lipid Peroxidation; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000378:metabolism*; D010084:Oxidation-Reduction / Q000187:drug effects; D019518:Postprandial Period; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D007004:Hypoglycemic Agents; D007328:Insulin; D014280:Triglycerides