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1دورية أكاديمية
المؤلفون: Fabricius, Therese W, Verhulst, Clementine EM, Kristensen, Peter L, Holst, Jens J, Tack, Cees J, McCrimmon, Rory J, Heller, Simon R, Evans, Mark L, de Galan, Bastiaan E, Pedersen-Bjergaard, Ulrik, Hypo-RESOLVE consortium
مصطلحات موضوعية: Counterregulatory response, Diabetes, Hyperinsulinaemic–hypoglycaemic clamp, Hypoglycaemia, Humans, Diabetes Mellitus, Type 1, Type 2, Male, Female, Hypoglycemia, Glucose Clamp Technique, Middle Aged, Adult, Insulin, Glucagon, Hypoglycemic Agents, Blood Glucose, Epinephrine, Aged, Case-Control Studies
الوصف: Acknowledgements: The authors thank Stine Tving Kjøller, Charlotte Hansen, Pernille Banck-Petersen and Rikke Carstensen for assisting as research nurses and Charlotte Pietraszek and Susanne Månsson for preparation of blood and other practicalities during the clamp in Denmark. We also thank Evertine Abbink, Linda Drenthen, Karin Saini, Marjolein Eybergen, Emma Lensen and Esther Eggenhuizen for assistance during the clamps in the Netherlands. ; Funder: National Health Service in the East of England through the Clinical Academic Reserve ; Funder: Copenhagen University ; AIM: The sympathetic nervous and hormonal counterregulatory responses to hypoglycaemia differ between people with type 1 and type 2 diabetes and may change along the course of diabetes, but have not been directly compared. We aimed to compare counterregulatory hormone and symptom responses to hypoglycaemia between people with type 1 diabetes, insulin-treated type 2 diabetes and controls without diabetes, using a standardised hyperinsulinaemic-hypoglycaemic clamp. MATERIALS: We included 47 people with type 1 diabetes, 15 with insulin-treated type 2 diabetes, and 32 controls without diabetes. Controls were matched according to age and sex to the people with type 1 diabetes or with type 2 diabetes. All participants underwent a hyperinsulinaemic-euglycaemic-(5.2 ± 0.4 mmol/L)-hypoglycaemic-(2.8 ± 0.13 mmol/L)-clamp. RESULTS: The glucagon response was lower in people with type 1 diabetes (9.4 ± 0.8 pmol/L, 8.0 [7.0-10.0]) compared to type 2 diabetes (23.7 ± 3.7 pmol/L, 18.0 [12.0-28.0], p < 0.001) and controls (30.6 ± 4.7, 25.5 [17.8-35.8] pmol/L, p < 0.001). The adrenaline response was lower in type 1 diabetes (1.7 ± 0.2, 1.6 [1.3-5.2] nmol/L) compared to type 2 diabetes (3.4 ± 0.7, 2.6 [1.3-5.2] nmol/L, p = 0.001) and controls (2.7 ± 0.4, 2.8 [1.4-3.9] nmol/L, p = 0.012). Growth hormone was lower in people with type 2 diabetes than in type 1 diabetes, at baseline (3.4 ± 1.6 vs 7.7 ± 1.3 mU/L, p = 0.042) and during hypoglycaemia (24.7 ± 7.1 vs ...
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2دورية أكاديمية
المؤلفون: Jones, Danielle L, Petry, Clive J, Burling, Keith, Barker, Peter, Turner, Elizabeth H, Kusinski, Laura C, Meek, Claire L
مصطلحات موضوعية: Gestational diabetes, Incretin, Insulin secretion, Insulin sensitivity, Obesity, Adult, Female, Humans, Pregnancy, Insulin, Glucagon-Like Peptide 1, Incretins, Diabetes, Gestational, Blood Glucose, Diabetes Mellitus, Type 2, Placenta, Glucose, Gastric Inhibitory Polypeptide
الوصف: Acknowledgements: The authors would like to thank all the nurses, doctors, administrative and laboratory staff in the different centres who helped recruit participants, administer the oral glucose tolerances tests, take and process the blood samples for this study. We are also grateful to the participants for taking part in this study. The incretin assays were performed by the National Institute for Health Research Core Biochemistry Assay Laboratory, Cambridge Biomedical Research Centre. The OPHELIA study was supported by a European Foundation for the Study of Diabetes—Sanofi grant for innovative measurement of diabetes outcomes and subsequently by support from the National Institute of Health Research Cambridge Biomedical Research Centre (BRC) and a National Institute of Health Research Clinical Research Network chief investigator award. The OPHELIA study was supported with staff time from the NIHR Clinical Research Network. C.L.M. is supported by the Diabetes UK Harry Keen Intermediate Clinical Fellowship (DUK-HKF 17/0005712) and a European Foundation for the Study of Diabetes—Novo Nordisk Foundation Future Leader’s Award (NNF19SA058974). ; Funder: NIHR Cambridge Biomedical Research Centre; doi: http://dx.doi.org/10.13039/501100018956Test ; AIMS: Incretin hormones glucagon-like peptide 1 (GLP-1) and gastric inhibitory peptide (GIP) cause increased insulin secretion in non-pregnant adults, but their role in pregnancy, where there are additional metabolically-active hormones from the placenta, is less clear. The aim of the present study was to assess if fasting and post-load incretin concentrations were predictive of pregnancy insulin and glucose concentrations. METHODS: Pregnant women (n = 394) with one or more risk factors for gestational diabetes were recruited at 28 weeks for a 75 g oral glucose tolerance test (OGTT). Glucose, insulin, GLP-1 and GIP were measured in the fasting state and 120 min after glucose ingestion. RESULTS: Fasting plasma GLP-1 concentrations were associated with plasma insulin ...
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