The Effect of Insulin on the Metabolism of Parenteral Maltose in Man Maltose in Man*

Young, Eleanor; Drummond, Alonzo; Cool, David A.; Cioletti, Louis A.; Crain, Marilyn J.; Traylor, Jill B.; Weser, Elliot

doi:10.1210/jcem-50-4-764

Cited by 18 publications

(4 citation statements)

References 48 publications

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“…In contrast to intraperitoneal glucose solutions, maltose and related metabolites of icodextrin do not affect glucose metabolism or lead to hyperinsulinemia (24). The observed prolonged hyperglycemic response to the oral glucose tolerance test in this study may indicate a degree of insulin resistance in these CAPD patients, conforming to other reports (11,25).…”

Section: Discussionsupporting

confidence: 86%

Effects of Peritoneal Dialysis with an Overnight Icodextrin Dwell on Parameters of Glucose and LIPID Metabolism

et al. 2001

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Objective To examine whether a reduced daily glucose load by overnight application of the less-absorbed glucose polymer icodextrin would have favorable effects on lipid profiles of continuous ambulatory peritoneal dialysis (CAPD) patients. Study Design Randomized crossover study with two subsequent periods of 6 weeks. Setting Home PD unit of a secondary-care hospital. Patients Twenty-one nondiabetic CAPD patients (15 male, 6 female; mean age 50.3 ± 11.8 years). Intervention Participants were randomly assigned to receive an overnight dwell with either standard glucose solution or with a 7.5% icodextrin-containing solution. Main Outcome Measures Relation between reduction in the total amount of intraperitoneal infused glucose and parameters of glucose (plasma glucose, insulin, and HbA1C) and lipid metabolism [free fatty acids, plasma lip-ids, lipoproteins, and low density lipoprotein (LDL) sub-fraction profile]. Results After the icodextrin dwells, a reduction of plasma total cholesterol (from 5.43 ± 0.85 to 4.86 ± 0.70 mmol/L, p < 0.001) and LDL cholesterol (from 3.38 ± 0.87 to 2.93 ± 0.73 mmol/L, p = 0.001) was observed. Also, high density lipoprotein (HDL) cholesterol (from 0.95 ± 0.27 to 0.90 ± 0.24 mmol/L, p = 0.029) was reduced, but the plasma total cholesterol-to-HDL ratio remained similar. Plasma free fatty acids and triglyceride levels tended to decrease (from 0.16 ± 0.10 to 0.13 ± 0.08 mmol/L, p = 0.06, and from 2.14 ± 1.96 to 1.92 ± 1.03 mmol/L, respectively). Evaluation of LDL subfraction profiles after ultra-centrifugation showed a more buoyant LDL subfraction profile with fewer dense LDL particles in 6 patients and no changes in 14 patients after icodextrin. The effects on lipids were not accompanied by a decrease in fasting plasma glucose (from 5.76 ± 1.29 to 5.86 ± 0.80 mmol/L) or insulin levels (from 19.5 ± 14.4 to 20.3 ± 13.0 mU/L). Conclusion These results suggest a beneficial effect on lipid profiles of CAPD patients with the use of an overnight dwell with icodextrin.

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Section: Discussionsupporting

confidence: 86%

Effects of Peritoneal Dialysis with an Overnight Icodextrin Dwell on Parameters of Glucose and LIPID Metabolism

et al. 2001

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“…The increases in both plasma glucose and IRI suggest that in fact it is. This is similar to the situation with maltose in healthy human subjects (10) and sucrose in dogs (11). Circulating and tissue maltases are most likely responsible for this meta bolism (12,13).…”

Section: Discussionsupporting

confidence: 84%

“…It is probable that the increase in IRI is not due to a direct effect of palatinose on the pancreatic B cells as evidenced by our experiments on isolated rat pancreas (4). (10) reported that maltose infusion at a rate of 2.5 and 5.0mg/kg/min in healthy males for 12h resulted in 34.8% and 53.3% loss in the urine, respectively. Since maltose is already being used as a parenteral nutrient in Japan, palatinose should be a suitable substitute under these criteria.…”

Section: Discussionmentioning

confidence: 99%

Palatinose as a potential parenteral nutrient: Its metabolic effects and fate after oral and intravenous administration to dogs.

Kawai

Okuda

Chiba

et al. 1986

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

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“…In contrast to intraperitoneal glucose solutions, maltose and related metabolites of icodextrin are reported not to affect glucose metabolism or lead to hyperinsulinemia. [15] The MIDAS study on efficacy and safety of icodextrin in CAPD demonstrated an overnight ultrafiltration achieved by icodextrin equal to a 3.86% glucose solution. [11] Also, long-term use of icodextrin had no detrimental influence on peritoneal ultrafiltration capacity, [11] and the routine use of icodextrin did not deteriorate the peritoneal defense mechanism.…”

Section: Discussionmentioning

confidence: 99%

Effect of Peritoneal Dialysis Solution Type on Serum Lipid Levels in End-Stage Renal Disease

et al. 2007

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Among the different cardiovascular risk factors, lipid abnormalities dominate the high mortality in chronic ambulatory peritoneal dialysis patients. So far, no data comparing the effect of standard glucose-containing, amino acid-containing, and icodextrin-containing peritoneal dialysis solutions on serum lipid concentrations in a chronic ambulatory peritoneal dialysis population are available. To determine the effect of peritoneal dialysis solutions on parameters of lipid metabolism, 67 subjects who had continued their usual dialysis for the last six months were enrolled in the study. Group A consisted of 18 patients who were receiving only glucosebased peritoneal dialysis solutions, group B consisted of 18 patients who were receiving glucose and amino acid-based peritoneal dialysis solutions, and group C consisted of 31 patients who were receiving glucose and icodextrin-based peritoneal dialysis solutions. Serum lipid parameters including total cholesterol, low-density lipoprotein, high-density lipoprotein, triglyceride, and lipoprotein (a) were determined in all groups. No significant difference in serum lipid parameters was found between groups A, B, and C. These results demonstrate the lack of the effect of amino acid or icodextrin-based peritoneal solutions on dyslipidemia of CAPD patients.

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The Effect of Insulin on the Metabolism of Parenteral Maltose in Man Maltose in Man*

Cited by 18 publications

References 48 publications

Effects of Peritoneal Dialysis with an Overnight Icodextrin Dwell on Parameters of Glucose and LIPID Metabolism

Effects of Peritoneal Dialysis with an Overnight Icodextrin Dwell on Parameters of Glucose and LIPID Metabolism

Palatinose as a potential parenteral nutrient: Its metabolic effects and fate after oral and intravenous administration to dogs.

Effect of Peritoneal Dialysis Solution Type on Serum Lipid Levels in End-Stage Renal Disease

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