Oral Glucose Augmentation of Insulin Secretion

Andersen, Dana K.; Elahi, Dariush; Brown, John C.; Tobin, Jordan D.; Andres, Reubin

doi:10.1172/jci109100

Cited by 220 publications

(42 citation statements)

References 41 publications

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“…In order to investigate further the role of the increased GIP levels in insulin secretion, 5-g IV glucose injections were given 1 h after the oral ingestion of lentils with or without fat. The intravenous injection raised plasma glucose levels above the reported threshold necessary for GIP to potentiate insulin secretion [21]. However, the insulin response was not affected by co-ingestion of fat, despite large differences in GIP levels.…”

Section: Discussionmentioning

confidence: 86%

Effect of co-ingestion of fat on the metabolic responses to slowly and rapidly absorbed carbohydrates

1984

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Summary. The present study examined the acute effects of coingestion of fat (37.5 g) on the post-prandial metabolic responses to 75 g of carbohydrate which was either slowly absorbed (lentils) or rapidly absorbed (potatoes). Co-ingestion of fat resulted in a significant flattening of the post-prandial glucose curves, the effect being more pronounced for the rapidly absorbed potatoes. This was probably due to delayed gastric emptying. However, the post-prandial insulin responses to either carbohydrate were not significantly reduced by fat, suggesting that the insulin response to a given glucose concentration was potentiated in the presence of fat. The gastric inhibitory polypeptide (GIP) responses to both carbohydrates were greatly increased in the presence of fat. To investigate further the possible roles of GIP in the entero-insular axis, a 5-g bolus of glucose was injected intravenously i h after lentils_ fat. This was sufficient to raise the glucose levels above the threshold reported for GIP to potentiate insulin secretion. However, despite the large differences in circulating GIP levels, the insulin response to glucose was not affected by the presence of fat. These results suggest that (1) the rate of absorption of carbohydrate is a major determinant of post-prandial metabolic responses even in the presence of fat, (2) fat-stimulated GIP secretion does not potentiate glucose-induced insulin secretion, and (3) the potentiation of the insulin response to glucose when carbohydrate is co-ingested with fat is consistent with the well-documented insulin resistance associated with high fat diets.Key words: Insulin, gastric inhibitory polypeptide, insulin sensitivity, glucose tolerance, diabetes, diet, fat, rate of carbohydrate digestion.Several studies have demonstrated the beneficial effects of high-carbohydrate, high-fibre diets in the treatment of Type 2 (non-insulin-dependent) diabetes [1,2]. The mechanism by which this dietary regimen improves long-term diabetic control remains unclear: is it due to the high complex carbohydrate, high fibre, type of fibre or low fat contents of such diets? Most previous studies have concentrated on the acute responses to complex carbohydrate and fibre components of the diet [3][4][5], and have highlighted the importance of rate of intestinal digestion and absorption in determining the metabolic responses to different carbohydrates. It has been suggested that these acute metabolic changes form the basis of long-term benefits associated with high-carbohydrate, high-fibre diets.However, as these diets are also low in fat, and insulin sensitivity has been demonstrated to be inversely related to the fat content of the diet [6,7], it is possible that * Present address: University of Melbourne, Department of Medicine, Repatriation General Hospital, Heidelberg West, Victoria, 3081, Australia the improved metabolic control is due (at least in part) to the low fat content. Thus, the aim of the present study was to examine the acute interaction of two components of the high-carbohydrate...

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Section: Discussionmentioning

confidence: 86%

Effect of co-ingestion of fat on the metabolic responses to slowly and rapidly absorbed carbohydrates

1984

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“…In adults, GIP-stimulated insulin response has been shown to be glucose dependent (17). An incremental glucose rise of 1' 7 mg/dL over fasting, or a threshold plasma glucose concentration of 105 mg/dL or g r a t a was required (18) for GIP-mediated enhanced insulin response to occur.…”

Section: Discussionmentioning

confidence: 99%

Functional Enteroinsular Axis in Full-Term Newborn Infants

1989

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ABSTRACT. The term "enteroinsular axis" refers to the AGA, appropriate for gestational age enhancement of insulin release by hormones secreted from SGA, small for gestational age the gut. Gastric inhibitory polypeptide (GIP) is one of theLGA, large for gestational age major hormones that mediates this function. The purpose IDM, infant of diabetic mother of the present study was to examine whether the enteroin-IRI, immunoreactive insulin sular axis is functional in newborn infants born at term gestation. Between d 2 and d 4 of life, glucose was infused for 2 h intravenously or orogastrically to 44 fullterm newborn infants, of whom 18 were appropriate for gestational age, nine large for gestational age, eight small for gestational age; nine infants were born to diabetic mothers. Glucose was infused at either 8 mg/kg/min intravenously or 16 mg/kg/min orogastrically to achieve similar plasma glucose concentrations. Plasma insulin and GIP concentrations were compared. Plasma GIP concentration increased significantly with enteral glucose administration in all infants but remained unchanged with parenteral glucose infusion. The responses of plasma insulin and the insulin/ glucose ratio were significantly greater in infants receiving enterally than parenterally infused glucose. However, when glucose was infused orogastrically at a lower rate (8 mg/ kg/min), plasma GIP concentrations rose, but no enhancement of insulin response was detected, suggesting the importance of the role of circulating glucose in the "enteroinsular axis". The infants of diabetic mothers and the large-for-gestational-age infants had more rapid insulin response to orogastrically administered glucose, but their GIP responses were similar to that of normal infants. These findings suggest that, at term gestation, the newborn infants have a "functional" enteroinsular axis in response to glucose, i.e. the rising plasma GIP contributed in part to the enhanced insulin response to enterally infused glucose. However, the more rapid insulin response to enteral glucose in the infant of diabetic mothers probably results from the effect of intrauterine hyperglycemia. Our data could not separate the role of GIP in insulin response to enteral glucose in the infants of diabetic mothers. (Pediatr Res 25:490-495, 1989)

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“…The normal GIP response after oral glucose might be the result of suppression by the concomitant hyperinsulinism excerting a negative feedback control on GIP release. However, it has been shown that insulin does not suppress glucose induced GIP release [11]. Another possibility is that the utilization of nonesterified free fatty acids by the GIP cell may interfere with GIP secretion [12].…”

Section: Discussionmentioning

confidence: 99%

Oral glucose tolerance, insulin and gastric inhibitory polypeptide secretion in patients recovered from acute myocardial infarction

1981

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Summary. Ten male patients, recovered from acute myocardial infarction, and ten control subjects were investigated by a 50 g oral glucose tolerance test. All patients and control subjects had flormal glucose tolerance, but the patients had increased fasting and integrated insulin response to oral glucose. Fasting gastric inhibitory polypeptide concentrations and integrated gastric inhibitory polypeptide response were normal in the patients. The exaggerated insulin secretion in patients recovered from myocardial infarction does not seem to be caused by increased secretion of gastric inhibitory polypeptide. Key words:Oral glucose tolerance, insulin, GIP, myocardial infarction, coronary artery disease.known to affect glucose tolerance or insulin secretion. A 50 g oral glucose tolerance test was carried out. Plasma glucose was determined by the glucose oxidase method. Insulin and plasma GIP were measured by radioimmunoassay [5]. The insulin antiserum used binds proinsulin and insulin with equimolar potency. The inter-assay coefficient of variation was 25.7% at 7 ~tU/ml and 7.1% at 52 ~tU/ml. The intra-assay coefficients of variation were 1.4% and 8.4% at the same concentrations. Plasma GIP was measured by a single antibody radioimmunoassay. The anti-GIP serum used in the assay reacts primarily with the 5000 mol. wt. component in human plasma [6]. The lower limit of detection was 20 pg/ml (zero standard + 2 SD). A reference plasma with a GIP concentration of 640 pg/ml showed an inter-assay coefficient of variation of 16% and an intra-assay coefficient of variation of 14%. Non-parametric analysis (Mann-Whitneys rank sum test) was used for analysis of the results. Glucose, insulin, and GIP areas under the curve above the fasting levels plotted over a period of 3 h were measured by planimeter.Plasma glucose and plasma insulin after oral glucose are increased in patients with coronary heart disease [1, 2]. In contrast IV glucose has a variable effect on insulin release in patients with coronary heart disease [3]. These observations suggest a possible hyperfunction of the entero-insular axis mediating the hyperinsulinism. Gastric inhibitory polypeptide (GIP) exerts a glucose dependent insulinotropic effect causing insulin release in the hyperglycaemic state [4]. We have studied the role of GIP in hyperinsulinaemia in patients after acute myocardial infarction. Material and MethodsThe group consisted of 10 males, fully mobilized on a normal diet. All had suffered an uncomplicated acute myocardial infarction 8-10 weeks before the investigation. They were 40-55 years of age and with a weight distribution of 95-125% of ideal body weight. The controls were 10 healthy male volunteers who had undergone minor surgical procedures 8 weeks previously. They were matched for .age and body weight. No subject received drugs 10

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Oral Glucose Augmentation of Insulin Secretion

Cited by 220 publications

References 41 publications

Effect of co-ingestion of fat on the metabolic responses to slowly and rapidly absorbed carbohydrates

Effect of co-ingestion of fat on the metabolic responses to slowly and rapidly absorbed carbohydrates

Functional Enteroinsular Axis in Full-Term Newborn Infants

Oral glucose tolerance, insulin and gastric inhibitory polypeptide secretion in patients recovered from acute myocardial infarction

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