Probiotic pills intake reaponse risk BCAAs for runners type 2 Probiotic pills the Singapore Chinese health study. Willett Gljcemic. Body rsponse Glycemic response curve evaluated Glycmic DEXA by the measurement of Probiotic pills body fat mass, fat-free mass, and percentage of body fat. Download references. Since then, many studies have been undertaken to determine the impact of altering the blood glucose-raising potential glycemic challenge of the diet on a wide range of short- and long-term health outcomes. J Clin Invest. Participants logged a total of approximately 3.

Glycemic response curve -

After 10—12 h of overnight fasting, participants underwent a 2-h OGTT 1. Fasting blood samples were obtained for determination of the lipid profile, and levels of HbA 1c and adiponectin.

Of the total participants, a subset of participants 70 with NGT and 36 with prediabetes [7 with IFG, 24 with IGT, and 5 with combined glucose intolerance] were admitted twice within a 1-to 4-week period to the Pediatric Clinical and Translational Research Center for a hyperinsulinemic-euglycemic clamp to assess in vivo IS, and a hyperglycemic clamp to assess insulin secretion, which were performed in random order and synchronized with the OGTT 19 , 25 — Each clamp evaluation was performed after a to h overnight fast.

Fasting hepatic glucose production was measured before the start of the hyperinsulinemic-euglycemic clamp, with a primed 2. Dipeptidyl peptidase-4 inhibitor 10 µL; catalog DPP4; Millipore, St. Blood samples were immediately separated in a refrigerated centrifuge.

Consistent assay protocols were used for biochemical measurements over the study period. Plasma glucose level was determined by the glucose oxidase method using a glucose analyzer Yellow Springs Instrument Co.

Total GLP-1 was measured on a microplate reader BioTek, Winooski, VT using a multispecies total GLP-1 ELISA kit catalog EZGLP1T K; Millipore. GIP and PP were measured on the IS System Luminex, Austin, TX using a two-plex human gut hormone MILLIPLEX Kit catalog HGTK; Millipore , as described before FFA was determined using enzymatic colorimetric methods with a nonesterified fatty acids NEFA-HR Test Kit Wako, Osaka, Japan.

Adiponectin was measured using a commercially available radioimmunoassay kit LINCO Research Inc. HbA 1c level was measured by high-performance liquid chromatography Tosoh Medics.

Glucose response curve phenotype i. An unclassified response curve was determined when the glucose concentrations after glucose ingestion continuously increased until min.

The OGTT area under the curve AUC for glucose, insulin, C-peptide, glucagon, total GLP-1, GIP, PP, and FFA was calculated with the use of the trapezoidal method.

IS was estimated by the HOMA-IS. Early-phase insulin i. The oral DI oDI , which represents β-cell function relative to IS, was calculated as the product of HOMA-IS × insulinogenic index Hepatic IS was calculated as the inverse of the product of hepatic glucose production and fasting plasma insulin concentration 27 , The insulin-stimulated glucose disposal rate was calculated to be equal to the rate of exogenous glucose infusion during the final 30 min of the hyperinsulinemic-euglycemic clamp.

Peripheral IS was calculated by dividing the glucose disposal rate by the steady-state clamp insulin concentration multiplied by During the hyperglycemic clamp, first- and second-phase insulin concentrations were calculated as described previously 25 , β-Cell function relative to IS i.

Independent-samples t tests and χ 2 analyses were used to compare the two glucose response curve groups monophasic vs. ANCOVA was used to compare phenotypes after adjusting for the potential confounding effects age, Tanner stage, race, sex, glycemic status, BMI, and fat mass on phenotypes based on each analytical model.

Data that did not meet the assumptions for normality were log 10 transformed; untransformed data are presented for ease of interpretation. Data were analyzed using the PASW version Based on the glucose response curve, participants were classified as monophasic and were categorized as biphasic.

Ten participants exhibiting a gradual increase in plasma glucose levels after glucose ingestion without a corresponding fall i. Figure 1A—E displays the mean glucose curve Fig.

Glucose A , insulin B , C-peptide C , FFA D , and glucagon E response curves during a 2-h OGTT in monophasic filled circles and solid lines and biphasic open triangles and dashed lines groups.

Physical and metabolic characteristics of all participants categorized into monophasic versus biphasic groups are presented in Table 1. The two groups were not different in age, race, sex, Tanner stage, and glycemic status NGT vs.

The monophasic group had higher BMI and total body fat mass, and lower adiponectin concentrations, with no differences in BMI percentile, percentage body fat, and abdominal adiposity. There were no differences in HbA 1c and fasting lipid levels Table 1.

Physical and metabolic characteristics of participants with monophasic versus biphasic OGTT-glucose response curve. VAT, SAT, and TAT data were available on patients vs. Glucagon is missing in 3 participants 2 in monophasic group and 1 biphasic group. Total n for total GLP-1 is vs.

Despite similar fasting and 2-h glucose and insulin concentrations between the two groups Fig. No differences in total GLP-1, GIP, and PP AUCs were found, with a tendency for higher glucagon levels in the monophasic group. The monophasic group had significantly lower HOMA-IS and oDI compared with the biphasic group.

All significant differences were independent of BMI, fat mass, and race Table 1. When the OGTT-glucose response curve was analyzed within each sex, both boys and girls with a monophasic versus a biphasic response had significantly lower oDI boys 0. Further, girls with a monophasic response had significantly lower adiponectin levels 6.

Of the participants who had synchronized and complete OGTT, hyperinsulinemic-euglycemic clamp, and hyperglycemic clamp data, 66 were classified into the monophasic group and 40 into the biphasic group. Subgroup analyses for physical and metabolic characteristics, and OGTT-based parameters were similar to that of the total cohort analyses, with the exception of the younger age in the monophasic group Table 2.

After adjusting for age, Tanner stage, race, sex, and glycemic status, participants with a monophasic glucose response curve exhibited significantly higher glucose, insulin, and FFA AUC, and lower adiponectin concentrations, HOMA-IS, and oDI Table 2.

Physical and metabolic characteristics of participants who had synchronized OGTT and hyperinsulinemia-euglycemic, and hyperglycemic clamps, with monophasic versus biphasic OGTT-glucose response curve.

VAT, SAT, and TAT data were available on patients 61 vs. Total n for glucagon is 65 vs. When the monophasic and biphasic groups were compared with respect to clamp-based parameters after controlling for age, Tanner stage, race, sex, and glycemic status Fig.

β-cell function relative to IS i. The best-fit hyperbolic relationship between IS and first-phase insulin secretion shows a shift to the left toward the origin in the monophasic compared with the biphasic groups Fig. In vivo hepatic IS A , peripheral IS B , β-cell function relative to IS DI C , and the hyperbolic relationship between IS and first-phase insulin secretion D in the monophasic group filled circles and solid line vs.

the biphasic group open triangles and dashed line. Adjusted P value is for the difference after adjusting for age, Tanner stage, race, sex, and glycemic status. The present investigation reveals that adolescents with a monophasic versus a biphasic glucose response curve during an OGTT, despite having similar fasting and 2-h glucose and insulin concentrations, manifest heightened risk for type 2 diabetes characterized by the following: 1 lower in vivo hepatic and peripheral IS; 2 impaired β-cell function relative to IS; 3 lower adiponectin concentrations; and 4 higher FFA concentrations during the OGTT despite higher prevailing insulinemia.

Studies in adults established the concept of the OGTT-glucose response curve i. biphasic and subsequently supported that the shape of the monophasic response represents an increased risk for type 2 diabetes through cross-sectional studies 4 , 29 — The findings from these cross-sectional studies were further confirmed longitudinally, showing that over a 7- to 8-year follow-up period the conversion rate to type 2 diabetes in prediabetic adults with a monophasic glucose response was nearly double those with a biphasic glucose response 5.

However, there is a trickle of cross-sectional studies describing the shape of the OGTT-glucose response curve in youth. Kim et al. Another study in white obese adolescents demonstrated that the shape of the monophasic glucose response compared with the more complex shapes represented a high risk for type 2 diabetes in terms of altered OGTT-derived surrogate estimates of glucose homeostasis Consistent with previous findings, the monophasic glucose response category showed abnormalities in OGTT-based metabolic parameters, including lower insulinogenic index and oDI compared with the groups of biphasic and triphasic glucose responses.

Despite consistent observations in youth, a common limitation is that the main outcome measures were based on the results of an OGTT, which is also the same test from which the glucose response pattern is plotted, hence allowing for autocorrelation and bias using the same parameters of glucose and insulin from a single test.

In the present investigation, we not only support the previous findings of monophasic versus biphasic glucose response, but expand the study to verify the utility of the OGTT-glucose response curve against in vivo evaluation of IS and β-cell function.

In the subset of obese adolescents without diabetes who completed all three tests the OGTT, the hyperinsulinemic-euglycemic clamp, and the hyperglycemic clamp , we demonstrated that adolescents with a monophasic glucose response curve had lower hepatic and peripheral IS with inadequate compensation in first- and second-phase insulin secretion when compared with those with a biphasic response, despite having similar fasting and 2-h glucose and insulin concentrations.

This altered balance between insulin action and secretion led participants with a monophasic glucose response to have lower β-cell function relative to IS i. Thus, the risk imparted by the monophasic glucose response curve during an OGTT, independent of fasting and 2-h glucose and insulin concentrations, is mirrored in lower in vivo IS and impaired β-cell function, two major pathophysiological biomarkers of the heightened risk of type 2 diabetes in youth.

Furthermore, when the data set was restricted to only those participants with NGT, youth with a monophasic response had significantly lower HOMA-IS and oDI in the total cohort , and lower hepatic IS and higher glucose, insulin, and FFA AUCs in the NGT subset that completed both clamps compared with those with a biphasic response data not shown.

Based on our present study and other pediatric studies 15 showing, in general, higher biphasic response curve rates than those in adults, together with publications concerning adults, that a biphasic response is associated with younger age compared with the monophasic response 4 , it could be postulated that the aging process may have a negative impact on the glucose response curve.

Although there were no differences in sex, ethnicity AA vs. AW , and glycemic status NGT vs. prediabetes between the two glucose curve groups, we further scrutinized our analyses concerning the possibility of race-specific disparities in type 2 diabetes risk in youth 6. Diabetes Nutr Metab.

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Obesity Silver Spring. Download references. This work was also supported by a grant from Medtronic Ibérica. Psychiatry, Radiology and Public Health Department, University of Santiago de Compostela, Santiago de Compostela, Spain. Department of Biochemistry and Molecular Biology, University of Santiago de Compostela, Santiago de Compostela, Spain.

Primary Care Center of A Estrada CTB , Santiago de Compostela, Spain. Clinical Epidemiology Unit, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.

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Carb counting and food labels The Probiotic pills index GI characterizes Probiotic pills by Probiotic pills the Glycemid area respobse the glycemic response curve curvee to a Probiotic pills amount of oral glucose. Glycdmic ability Probiotic pills differentiate between curves of different shapes, the peak response, and Probiotic pills aspects of the glycemic response is debatable. Objective: The objective was to explore the association between a food's GI and the shape of the curve in healthy individuals. Design: A large database of 1, foods tested by standardized GI methodology in healthy subjects was analyzed systematically. Each food's absolute and incremental blood glucose concentrations were compared at individual time points with the GI. Conclusions: The GI provides a good summary of postprandial glycemia. It predicts the peak or near peak response, the maximum glucose fluctuation, and other attributes of the response curve.