Insulin Absorption, Glucose Homeostasis, and Lipolysis in IDDM During Mental Stress

Fernqvist‐Forbes, E.; Linde, Birgitta

doi:10.2337/diacare.14.11.1006

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…These differences have been found to correlate with blood flow in some studies [16][17][18][19] but not others. [20][21][22][23] Within the abdominal subcutaneous adipose tissue depot, insulin absorption has been shown to be faster in the upper, epigastric area compared with lower sites of the abdomen 12 but no differences in ATBF were found between the two sites. 23 However, the xenon washout technique used in that paper to measure ATBF has since been improved by using g counters attached to the skin.…”

Section: Introductionmentioning

confidence: 89%

Subcutaneous adipose tissue blood flow varies between superior and inferior levels of the anterior abdominal wall

et al. 2003

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OBJECTIVE: Blood flow regulation is thought to mediate the metabolic functions of adipose tissue. Different depots, and even different layers within the subcutaneous adipose tissue, may vary in metabolic activity and blood flow. Therefore, we investigated if any differences in subcutaneous adipose tissue blood flow (ATBF) exist at different locations of the anterior abdominal wall. METHODS: ATBF was measured 8-10 cm above or below the umbilicus, at 8-10 cm (both sides) from the midline, in 18 healthy subjects (BMI range 18-33 kg/m 2 ). Measurements of ATBF were performed using 133 xenon washout, during a stable baseline period and after ingestion of 75 g of glucose. RESULTS: At baseline, ATBF was greater at the upper level compared to the lower level (4.470.3 vs 3.870.2 ml min À1 100 g tissue À1 , P ¼ 0.005), but was not different between the right and the left sides at either level. ATBF increased in response to oral glucose at all sites. The mean increase at the superior level was also greater than the inferior level (3.570.7 vs 2.270.6 ml min À1 100 g tissue À1 , P ¼ 0.001). CONCLUSIONS: Even at a constant depth and with only 16-20 cm difference between sites, there are significant differences in function of the same adipose depot. These findings have physiological and methodological implications for in vivo metabolic studies of human adipose tissue.

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Section: Introductionmentioning

confidence: 89%

Subcutaneous adipose tissue blood flow varies between superior and inferior levels of the anterior abdominal wall

et al. 2003

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“…mayoclinicproceedings.org) (Irl B. Hirsch, MD, oral communication, October 24, 2015). 88,[160][161][162][163][164][165][166][167][168][169][170][171][172][173][174][175][176][177] Lipoatrophy studies are also summarized at this site.…”

Section: Therapeutic Educationmentioning

confidence: 99%

New Insulin Delivery Recommendations

Frid

Kreugel

Grassi

et al. 2016

Mayo Clinic Proceedings

234

278

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Many primary care professionals manage injection or infusion therapies in patients with diabetes. Few published guidelines have been available to help such professionals and their patients manage these therapies. Herein, we present new, practical, and comprehensive recommendations for diabetes injections and infusions. These recommendations were informed by a large international survey of current practice and were written and vetted by 183 diabetes experts from 54 countries at the Forum for Injection Technique and Therapy: Expert Recommendations (FITTER) workshop held in Rome, Italy, in 2015. Recommendations are organized around the themes of anatomy, physiology, pathology, psychology, and technology. Key among the recommendations are that the shortest needles (currently the 4-mm pen and 6-mm syringe needles) are safe, effective, and less painful and should be the first-line choice in all patient categories; intramuscular injections should be avoided, especially with long-acting insulins, because severe hypoglycemia may result; lipohypertrophy is a frequent complication of therapy that distorts insulin absorption, and, therefore, injections and infusions should not be given into these lesions and correct site rotation will help prevent them; effective long-term therapy with insulin is critically dependent on addressing psychological hurdles upstream, even before insulin has been started; inappropriate disposal of used sharps poses a risk of infection with blood-borne pathogens; and mitigation is possible with proper training, effective disposal strategies, and the use of safety devices. Adherence to these new recommendations should lead to more effective therapies, improved outcomes, and lower costs for patients with diabetes.

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Acute mental stress impairs insulin sensitivity in IDDM patients

et al. 1994

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The effect of acute mental stress on insulin sensitivity was evaluated in ten IDDM patients, studied on two occasions (test day and control day) in random order and separated by a period of 1-3 weeks. Mental stress was evoked by a modified filmed version of Stroop's CWT for 20 min. On the control day, the patients were resting quietly during the corresponding period. Insulin sensitivity was estimated by an insulin (0.4 mU.kg-1 x min-1)-glucose (4.5 mg.kg-1 x min-1)-infusion test (IGIT) for 6.5 h. Mental stress evoked significant responses for adrenaline, cortisol and GH, their respective peak values being 0.27 +/- 0.05 nmol/l, 426 +/- 27 nmol/l and 7.6 +/- 1.8 micrograms/l, as well as increases in systolic and diastolic blood pressure and pulse rate The steady-state blood glucose levels, i.e. the mean blood glucose levels 3-6.5 h after the start of the IGIT, were significantly higher after stress, compared with those on the control day, 10.6 +/- 1.5 vs 8.7 +/- 1.4 mmol/l, p = 0.01, demonstrating impairment of the insulin sensitivity by mental stress. It is concluded that acute mental stress induces a state of insulin resistance in IDDM patients, which can be demonstrated by an IGIT to appear 1 h after maximal stress and to last more than 5 h.

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Insulin Absorption, Glucose Homeostasis, and Lipolysis in IDDM During Mental Stress

Abstract: The results suggest that intense mental stress of 40 min duration does not alter the absorption of subcutaneously injected insulin, glucose homeostasis, or ketone body levels in patients with IDDM, despite a considerable increase in blood flow and lipolysis.

Cited by 3 publications

References 20 publications

Subcutaneous adipose tissue blood flow varies between superior and inferior levels of the anterior abdominal wall

Subcutaneous adipose tissue blood flow varies between superior and inferior levels of the anterior abdominal wall

New Insulin Delivery Recommendations

Acute mental stress impairs insulin sensitivity in IDDM patients

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