scholarly journals Small Intestinal Glucose Delivery Affects the Lowering of Blood Glucose by Acute Vildagliptin in Type 2 Diabetes

2016 ◽  
Vol 101 (12) ◽  
pp. 4769-4778 ◽  
Author(s):  
Tongzhi Wu ◽  
Xiang Zhang ◽  
Laurence G. Trahair ◽  
Michelle J. Bound ◽  
Tanya J. Little ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Emptying ◽  
Plasma Glucose ◽  
Glucose Infusion ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Glucose Lowering ◽  
C Peptide ◽  
Type 2 Diabetic

Context: The rate of gastric emptying is an important determinant of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) secretion and may influence the magnitude of glucose lowering by dipeptidyl peptidase-4 (DPP-4) inhibitors. Objective: To evaluate the effects of the DPP-4 inhibitor, vildagliptin (VILD), during intraduodenal (ID) glucose infusion at 2 different rates within the physiological range of gastric emptying, in type 2 diabetes. Participants and Design: A total of 16 diet-controlled type 2 diabetic patients were studied on 4 separate days in double-blind, randomized, fashion. On each day, either 5-mg VILD or placebo (PLBO) was given 60 minutes before a 120-minute ID glucose infusion at 2 or 4 kcal/min (ID2 or ID4). Plasma glucose and hormones were measured frequently. Results: Plasma glucose, insulin, C-peptide, glucagon, total GIP, and total and intact GLP-1 concentrations were higher during ID4 than ID2 (P < .01 for each). Compared with PLBO, VILD was associated with higher intact GLP-1, insulin, and C-peptide and lower glucose and total GIP and GLP-1 (P < .01 for each), without affecting glucagon. There were significant interactions between the rate of ID glucose and VILD treatment on plasma glucose, intact and total GLP-1, and GIP (P < .05 for each) but not insulin, C-peptide, or glucagon. The reduction in glucose and the increment in intact GLP-1 after VILD vs PLBO were 3.3- and 3.8-fold greater, respectively, during ID4 compared with ID2. Conclusions/Interpretation: These observations warrant further study to clarify whether type 2 diabetic patients with relatively more rapid gastric emptying have greater glucose lowering during treatment with DPP-4 inhibitors.

scholarly journals Body Mass Index, Fasting Plasma Glucose Levels, and C-peptide Levels as Predictors of the Future Insulin Use in Japanese Type 2 Diabetic Patients

2010 ◽  
Vol 57 (3) ◽  
pp. 237-244 ◽  
Author(s):  
Atsushi GOTO ◽  
Maki TAKAICHI ◽  
Miyako KISHIMOTO ◽  
Yoshihiko TAKAHASHI ◽  
Hiroshi KAJIO ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
C Peptide ◽  
Glucose Levels ◽  
Insulin Use ◽  
Type 2 Diabetic

scholarly journals Decrement of postprandial insulin secretion determines the progressive nature of type-2 diabetes

2006 ◽  
Vol 155 (4) ◽  
pp. 615-622 ◽  
Author(s):  
Wan Sub Shim ◽  
Soo Kyung Kim ◽  
Hae Jin Kim ◽  
Eun Seok Kang ◽  
Chul Woo Ahn ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Diabetic Patients ◽  
Β Cell ◽  
Type 2 Diabetic Patients ◽  
C Peptide ◽  
Duration Of Diabetes ◽  
Type 2 Diabetic ◽  
Postprandial Insulin

Objective: Type-2 diabetes is a progressive disease. However, little is known about whether decreased fasting or postprandial pancreatic β-cell responsiveness is more prominent with increased duration of diabetes. The aim of this study was to evaluate the relationship between insulin secretion both during fasting and 2 h postprandial, and the duration of diabetes in type-2 diabetic patients. Design: Cross-sectional clinical investigation. Methods: We conducted a meal tolerance test in 1466 type-2 diabetic patients and calculated fasting (M0) and postprandial (M1) β-cell responsiveness. Results: The fasting C-peptide, postprandial C-peptide, M0, and M1 values were lower, but HbA1c values were higher, in patients with diabetes duration > 10 years than those in other groups. There was no difference in the HbA1c levels according to the tertiles of their fasting C-peptide level. However, in a group of patients with highest postprandial C-peptide tertile, the HbA1c values were significantly lower than those in other groups. After adjustment of age, sex, and body mass index (BMI), the duration of diabetes was found to be negatively correlated with fasting C-peptide (γ = −0.102), postprandial C-peptide (γ = −0.356), M0 (γ = −0.263), and M1 (γ = −0.315; P < 0.01 respectively). After adjustment of age, sex, and BMI, HbA1c was found to be negatively correlated with postprandial C-peptide (γ = −0.264), M0 (γ = −0.379), and M1 (γ = −0.522), however, positively correlated with fasting C-peptide (γ = 0.105; P < 0.01 respectively). In stepwise multiple regression analysis, M0, M1, and homeostasis model assessment for insulin resistance (HOMA-IR) emerged as predictors of HbAlc after adjustment for age, sex, and BMI (R2 = 0.272, 0.080, and 0.056 respectively). Conclusions: With increasing duration of diabetes, the decrease of postprandial insulin secretion is becoming more prominent, and postprandial β-cell responsiveness may be a more important determinant for glycemic control than fasting β-cell responsiveness.

scholarly journals Annual fasting plasma glucose variation increases risk of cancer incidence and mortality in patients with type 2 diabetes: the Taichung Diabetes Study

2012 ◽  
Vol 19 (4) ◽  
pp. 473-483 ◽  
Author(s):  
Cheng-Chieh Lin ◽  
Chia-Ing Li ◽  
Chiu-Shong Liu ◽  
Wen-Yuan Lin ◽  
Ching-Chu Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cancer Incidence ◽  
Plasma Glucose ◽  
Care Management ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Incidence And Mortality ◽  
Type 2 Diabetic

The study aims to examine whether the annual variations in fasting plasma glucose (FPG) measurements, represented by the coefficient of variation (CV), predict cancer incidence and mortality in the subsequent years independent of traditional risk factors of type 2 diabetic patients. A computerized database of patients with type 2 diabetes of 30 years old and older (n=4805) enrolled in the Diabetes Care Management Program of a medical center before 2006 was analyzed using a time-dependent Cox's proportional hazards regression model. The mortality rates for the first, second, and third tertiles of the first annual FPG-CV were 8.64, 12.71, and 30.82 per 1000 person-years respectively. After adjusting for mean FPG, HbA1c, and other risk factors, the annual FPG-CV was independently associated with cancer incidence, cancer mortality, and cancer incidence or mortality, and the corresponding hazard ratios for the third vs first tertile of the annual FPG-CV were 3.03 (1.98, 4.65), 5.04 (2.32, 10.94), and 2.86 (1.91, 4.29) respectively. The annual variation in FPG was a strong predictor of cancer incidence and mortality in type 2 diabetic patients; therefore, glucose variation may be important in the clinical practice of care management and cancer prevention.

scholarly journals Impact of Comorbidities, Glycemia at Admission and DPP4 Inhibitors in Type 2 Diabetic Patients with COVID-19: a Case Series from an Academic Hospital in Lombardy, Italy

2020 ◽  
Author(s):  
Marco Mirani ◽  
Giuseppe Favacchio ◽  
Flaminia Carrone ◽  
Nazarena Betella ◽  
Emilia Biamonte ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Plasma Glucose ◽  
Case Series ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Glucose Levels ◽  
Risk Of Mortality ◽  
The Impact ◽  
Type 2 Diabetic

<a>OBJECTIVE</a> <p>Diabetes mellitus may unfavorably influence the outcome of Coronavirus disease-19 (COVID-19), <a>but the determinants of this effect are still poorly understood.</a></p> <p><a>In this monocentric study we aimed at evaluating the impact of type 2 diabetes, comorbidities, plasma glucose levels and </a>antidiabetic medications on the survival of COVID-19 patients.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>This was a case series involving 387 COVID-19 patients admitted to a single center in the region of Lombardy, the epicenter of the <a></a><a>Severe Acute Respiratory Syndrome Coronavirus-2 </a>(SARS-CoV2) pandemic in Italy, between February 20 and April 9, 2020.</p> <p>Medical history, pharmacological treatments, laboratory findings and clinical outcomes of non-diabetic and type 2 diabetic patients were compared. Cox proportional hazards analysis was applied to investigate risk factors associate with mortality.</p> <p>RESULTS</p> <p>Our samples included 90 patients (23.3%) with type 2 diabetes, who displayed double the mortality rate of non-diabetic subjects (42.3% vs 21.7%, <i>P</i> < 0.001). <a>In spite of this, after correction for age and sex, risk of mortality was significantly associated with a history of hypertension [adjusted hazard ratio (aHR) 1.84, 95% confidence interval (C.I.) 1.15-2.95; <i>P </i>= 0.011), coronary artery disease (aHR 1.56, 95% C.I. 1.04-2.35; <i>P </i>= 0.031), chronic kidney disease (aHR 2.07, 95% C.I. 1.27-3.38; <i>P </i>= 0.003), stroke (aHR 2.09, 95% C.I. 1.23-3.55; <i>P</i>=0.006) and cancer (aHR 1.57, 95% C.I. 1.08-2.42; <i>P </i>= 0.04), but not with type 2 diabetes (<i>P </i>= 0.170). </a></p> <p><a>In diabetic patients, elevated plasma glucose </a>(<a>a</a>HR 1.22, 95% C.I. 1.04 – 1.44 per mmol/l; <i>P </i>= 0.015) and IL-6 levels at admission [<a></a><a>aHR 2.47, 95% C.I. 1.28 – 4.78 per 1 standard deviation (SD) increase, <i>P </i>= 0.007</a>] as well as treatments with insulin (aHR 3.05, 95% C.I. 1.57-5.95; <i>P </i>= 0.001) and beta-blockers (aHR 3.20, 95% C.I. 1.50-6.60; <i>P </i>= 0.001) were independently associated with an increased mortality, whereas the use of DPP-4 inhibitors was significantly and independently associated with a lower risk of mortality (aHR 0.13, 95% C.I. 0.02 – 0.92, <i>P </i>= 0.042).</p> <p>CONCLUSIONS</p> <p><a></a><a>Plasma glucose levels at admission and antidiabetic drugs may influence the survival of COVID-19 patients affected by type-2 diabetes</a>.</p> <br>

scholarly journals Impact of Comorbidities, Glycemia at Admission and DPP4 Inhibitors in Type 2 Diabetic Patients with COVID-19: a Case Series from an Academic Hospital in Lombardy, Italy

2020 ◽  
Author(s):  
Marco Mirani ◽  
Giuseppe Favacchio ◽  
Flaminia Carrone ◽  
Nazarena Betella ◽  
Emilia Biamonte ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Plasma Glucose ◽  
Case Series ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Glucose Levels ◽  
Risk Of Mortality ◽  
The Impact ◽  
Type 2 Diabetic

<a>OBJECTIVE</a> <p>Diabetes mellitus may unfavorably influence the outcome of Coronavirus disease-19 (COVID-19), <a>but the determinants of this effect are still poorly understood.</a></p> <p><a>In this monocentric study we aimed at evaluating the impact of type 2 diabetes, comorbidities, plasma glucose levels and </a>antidiabetic medications on the survival of COVID-19 patients.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>This was a case series involving 387 COVID-19 patients admitted to a single center in the region of Lombardy, the epicenter of the <a></a><a>Severe Acute Respiratory Syndrome Coronavirus-2 </a>(SARS-CoV2) pandemic in Italy, between February 20 and April 9, 2020.</p> <p>Medical history, pharmacological treatments, laboratory findings and clinical outcomes of non-diabetic and type 2 diabetic patients were compared. Cox proportional hazards analysis was applied to investigate risk factors associate with mortality.</p> <p>RESULTS</p> <p>Our samples included 90 patients (23.3%) with type 2 diabetes, who displayed double the mortality rate of non-diabetic subjects (42.3% vs 21.7%, <i>P</i> < 0.001). <a>In spite of this, after correction for age and sex, risk of mortality was significantly associated with a history of hypertension [adjusted hazard ratio (aHR) 1.84, 95% confidence interval (C.I.) 1.15-2.95; <i>P </i>= 0.011), coronary artery disease (aHR 1.56, 95% C.I. 1.04-2.35; <i>P </i>= 0.031), chronic kidney disease (aHR 2.07, 95% C.I. 1.27-3.38; <i>P </i>= 0.003), stroke (aHR 2.09, 95% C.I. 1.23-3.55; <i>P</i>=0.006) and cancer (aHR 1.57, 95% C.I. 1.08-2.42; <i>P </i>= 0.04), but not with type 2 diabetes (<i>P </i>= 0.170). </a></p> <p><a>In diabetic patients, elevated plasma glucose </a>(<a>a</a>HR 1.22, 95% C.I. 1.04 – 1.44 per mmol/l; <i>P </i>= 0.015) and IL-6 levels at admission [<a></a><a>aHR 2.47, 95% C.I. 1.28 – 4.78 per 1 standard deviation (SD) increase, <i>P </i>= 0.007</a>] as well as treatments with insulin (aHR 3.05, 95% C.I. 1.57-5.95; <i>P </i>= 0.001) and beta-blockers (aHR 3.20, 95% C.I. 1.50-6.60; <i>P </i>= 0.001) were independently associated with an increased mortality, whereas the use of DPP-4 inhibitors was significantly and independently associated with a lower risk of mortality (aHR 0.13, 95% C.I. 0.02 – 0.92, <i>P </i>= 0.042).</p> <p>CONCLUSIONS</p> <p><a></a><a>Plasma glucose levels at admission and antidiabetic drugs may influence the survival of COVID-19 patients affected by type-2 diabetes</a>.</p> <br>

scholarly journals Effects of intragastric administration of L-tryptophan on the glycaemic response to a nutrient drink in men with type 2 diabetes — impacts on gastric emptying, glucoregulatory hormones and glucose absorption

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maryam Hajishafiee ◽  
Rachel A. Elovaris ◽  
Karen L. Jones ◽  
Leonie K. Heilbronn ◽  
Michael Horowitz ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Emptying ◽  
Plasma Glucose ◽  
Glucose Absorption ◽  
Intragastric Administration ◽  
Glycaemic Response ◽  
C Peptide ◽  
Postprandial Glycaemia ◽  
Glucoregulatory Hormones

Abstract Background The rate of gastric emptying and glucoregulatory hormones are key determinants of postprandial glycaemia. Intragastric administration of L-tryptophan slows gastric emptying and reduces the glycaemic response to a nutrient drink in lean individuals and those with obesity. We investigated whether tryptophan decreases postprandial glycaemia and slows gastric emptying in type 2 diabetes (T2D). Methods Twelve men with T2D (age: 63 ± 2 years, HbA1c: 49.7 ± 2.5 mmol/mol, BMI: 30 ± 1 kg/m2) received, on three separate occasions, 3 g (‘Trp-3’) or 1.5 g (‘Trp-1.5’) tryptophan, or control (0.9% saline), intragastrically, in randomised, double-blind fashion, 30 min before a mixed-nutrient drink (500 kcal, 74 g carbohydrates), containing 3 g 3-O-methyl-D-glucose (3-OMG) to assess glucose absorption. Venous blood samples were obtained at baseline, after tryptophan, and for 2 h post-drink for measurements of plasma glucose, C-peptide, glucagon and 3-OMG. Gastric emptying of the drink was quantified using two-dimensional ultrasound. Results Tryptophan alone stimulated C-peptide (P = 0.002) and glucagon (P = 0.04), but did not affect fasting glucose. In response to the drink, Trp-3 lowered plasma glucose from t = 15–30 min and from t = 30–45 min compared with control and Trp-1.5, respectively (both P < 0.05), with no differences in peak glucose between treatments. Gastric emptying tended to be slower after Trp-3, but not Trp-1.5, than control (P = 0.06). Plasma C-peptide, glucagon and 3-OMG increased on all days, with no major differences between treatments. Conclusions In people with T2D, intragastric administration of 3 g tryptophan modestly slows gastric emptying, associated with a delayed rise, but not an overall lowering of, postprandial glucose.

scholarly journals Impact of a Booklet about Diabetes Genetic Susceptibility and Its Prevention on Attitudes towards Prevention and Perceived Behavioral Change in Patients with Type 2 Diabetes and Their Offspring

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Masakazu Nishigaki ◽  
Eiko Sato ◽  
Ryota Ochiai ◽  
Taiga Shibayama ◽  
Keiko Kazuma
Keyword(s):  
Type 2 Diabetes ◽  
Genetic Susceptibility ◽  
Behavioral Change ◽  
Behavioral Changes ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
The Patient’S View ◽  
Self Administered Questionnaire ◽  
Type 2 Diabetic

Background. Offspring of type 2 diabetic patients are at a high risk of type 2 diabetes. Information on diabetes genetic susceptibility and prevention should be supplied to the offspring.Methods. A six-page booklet on diabetes genetic susceptibility and prevention was distributed to 173 patients who ere ordered to hand it to their offspring. The patients answered a self-administered questionnaire on booklet delivery and attitudinal and behavioral changes toward diabetes and its prevention in themselves and their offspring.Results. Valid responses were obtained from 130 patients. Forty-nine patients had actually handed the booklet. Booklet induces more relief than anxiety. From the patient's view, favorable attitudinal and/or behavioral changes occurred in more than half of the offspring who were delivered the booklet.Conclusion. The booklet worked effectively on attitudes and behaviors toward diabetes and its prevention both in patients and their offspring. However, the effectiveness of patients as information deliverers was limited.

Awareness of Complications in Diabetic Patients - Study in a Tertiary Care Centre in Kerala

2021 ◽  
Vol 8 (37) ◽  
pp. 3334-3338
Author(s):  
Satish Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Type 2 Diabetic Patients ◽  
Complications Of Diabetes ◽  
Type 2 Diabetic

BACKGROUND Type 2 diabetes mellitus is common in the Indian population and awareness regarding the disease and its complications is low among the patients with diabetes. There is lack of studies regarding awareness of complications of diabetes among type 2 diabetic patients. The purpose of this study was to assess the awareness of diabetic complications among type 2 diabetic patients. METHODS This is an institutional based observational study. The sample comprised of 150 adult patients with type 2 diabetes mellitus who underwent treatment in the Department of Medicine, Medical College Kottayam and the patient’s age ranged from 18 - 77 years. RESULTS Majority of patients were in the age group 38 to 57 and the sample comprised of 56 % males and 44 % female patients. Out of 150 patients involved in the study, 120 patients (80 %) were aware of the complications of diabetes mellitus. Among the male patients, 70 (83.33 %) and among females, 50 (75.75 %) were aware of the complications in diabetes. In the study sample, 92 (61.33 %) were aware of the foot problems, 120 patients (80 %) were aware of renal complications, 91 patients were aware regarding eye problems of diabetes, 38 (25.33 %) regarding development of hypertension, 62 (41.33 %) regarding heart attack, 42 (28 %) patients were aware regarding development of stroke and 78 patients (52 %) had awareness regarding occurrence of recurrent infections. CONCLUSIONS Awareness regarding diabetes and its complications is fairly good among the diabetic patients in Kerala. Awareness regarding all complications of diabetes was higher among males than females. Providing awareness to type 2 diabetic patients by various educational programs may be of further help to prevent complications and to decrease the mortality and morbidity in type 2 diabetes patients. KEYWORDS Awareness, Diabetes

scholarly journals Basal C-peptide Level as a Surrogate Marker of Subclinical Atherosclerosis in Type 2 Diabetic Patients

2011 ◽  
Vol 35 (1) ◽  
pp. 41 ◽  
Author(s):  
Sung-Tae Kim ◽  
Byung-Joon Kim ◽  
Dong-Mee Lim ◽  
In-Geol Song ◽  
Jang-Han Jung ◽  
...  
Keyword(s):  
Subclinical Atherosclerosis ◽  
Surrogate Marker ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
C Peptide ◽  
Peptide Level ◽  
Type 2 Diabetic
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