title: Does oral glutamine improve insulin sensitivity in adolescents with type 1 diabetes?
abstract: OBJECTIVE
  The decline in insulin sensitivity (SI) associated with puberty increases the difficulty of achieving glycemic control in adolescents with type 1 diabetes (T1D). The aim of this study was to determine whether glutamine supplementation affects blood glucose by enhancing SIin adolescents with T1D.
  
  
  METHODS
  Thirteen adolescents with T1D (HbA1C 8.2 ± 0.1%) were admitted to perform afternoon exercise (four 15-min treadmill/5-min rest cycles of exercise) on two occasions within a 4-wk period. They were randomized to receive a drink containing either glutamine (0.25 g/kg) or placebo before exercise, at bedtime, and early morning in a double-blind, crossover design. Blood glucose was monitored overnight, and a hyperinsulinemic-euglycemic clamp was performed the following morning.
  
  
  RESULTS
  Blood glucose concentration dropped comparably during exercise on both days. However, the total number of nocturnal hypoglycemic events (17 versus 7, P = 0.045) and the cumulative probability of overnight hypoglycemia (50% versus 33%, P = 0.02) were higher on the glutamine day than on the placebo day. During clamp, glucose infusion rate was not affected by glutamine supplementation (7.7 ± 1 mg • kg-1• min-1versus 7.0 ± 1; glutamine versus placebo; P = 0.4).
  
  
  CONCLUSIONS
  Oral glutamine supplementation decreases blood glucose in adolescents with T1D after exercise. Insulin sensitivity, however, was unaltered during the euglycemic clamp. Although the mechanisms involved remain to be elucidated, studies to explore the potential use of glutamine to improve blood glucose control are needed.
authors.affiliation: Department of Pediatric Endocrinology and Metabolism, Nemours Children's Health System, Jacksonville, Florida, USA.
authors.forename: Lournaris
authors.initials: L
authors.lastname: Torres-Santiago
authors.affiliation: Department of Pediatric Endocrinology and Metabolism, Nemours Children's Health System, Jacksonville, Florida, USA.
authors.forename: Nelly
authors.initials: N
authors.lastname: Mauras
authors.affiliation: Biostatistics Core, Nemours/A. I. duPont Hospital for Children, Wilmington, Delaware, USA.
authors.forename: Jobayer
authors.initials: J
authors.lastname: Hossain
authors.affiliation: Department of Kinesiology, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Weltman
authors.affiliation: Department of Pediatric Endocrinology and Metabolism, Nemours Children's Health System, Jacksonville, Florida, USA; INRA and University of Nantes, Nantes, France. Electronic address: Ddarmaun@nemours.org.
authors.forename: Dominique
authors.initials: D
authors.lastname: Darmaun
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D019587:Dietary Supplements; D004311:Double-Blind Method; D015444:Exercise; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D015309:Glucose Clamp Technique; D005973:Glutamine / Q000008:administration & dosage*; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male
chemical_list: D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007004:Hypoglycemic Agents; D007328:Insulin; D005973:Glutamine; D052216:Glucagon-Like Peptide 1
keywords: Amino acids; Exercise; GLP-1; Hyperinsulinemic-euglycemic clamp clamp; Hypoglycemia; Stable isotopes