Brazilian individuals with impaired glucose tolerance are characterized by impaired insulin secretion

Background: To better understand the pathogenesis of type 2 diabetes mellitus, insulin secretion and insulin sensitivity (IS) were evaluated in white Brazilians with impaired glucose tolerance (IGT), using the oral glucose tolerance test (OGTT) and the hyperglycemic clamp technique.Methods: Twenty-five IGT subjects were individually matched with normal glucose-tolerant (NGT) subjects for demographic characteristics, At first, they were submitted to the OGTT and plasma glucose and insulin were measured. of the 25 pairs, 20 could participate in the hyperglycemic clamp procedures, at a second visit. All participants had their plasma glucose levels equally increased to 180 mg/dl; this was maintained for three hours by variable glucose infusion. During the procedure, plasma glucose and insulin were measured at established intervals.Results: In the postabsorptive state, the IGT subjects presented higher levels of plasma glucose, blood HbA(1) and serum triglycerides, but similar plasma insulin levels. After the oral glucose load, early and total insulin release, in relation to glucose levels, were respectively, 43 and 67% lower in the IGT individuals, the index of whole-body IS was increased in the IGT individuals (4.36 +/- 1.71 vs 3.61 +/- 1.28 mg(-1).muU(-1) 100.ml(2); p < 0.05). By the hyperglycemic clamp technique first- (82 &PLUSMN; 26 vs 215 &PLUSMN; 88 μU/ml; p < 0.001) and second- (36 +/- 19 vs 73 +/- 44 muU/ml; p < 0.05) phases of insulin secretion was decreased in the IGT individuals, especially the first one. However, the groups did not differ in relation to the IS: IGT = 13.52 &PLUSMN; 7.27 and NGT = 9.96 &PLUSMN; 6.70 mg.ml/kg.μU.min(-1); p > 0.05. Functional relationship of IS (y) on first-phase insulin release (x) showed a smaller (p < 0,05) regression coefficient for the IGT group.Conclusion: Brazilians with IGT well-matched with NGT ones were characterized by impaired first- and second-phase insulin secretion (mainly the former), while defects in IS were not evident.

Influence of nutrition on the glucose absorption and tolerance test in horses submitted to different fasting periods

Four groups of horses of Brasileiro de Hipismo bred were submitted to fasting for 24 and 48 hours in order to study the absorption capacity of the small intestine. Two groups were fed with coast cross grass (Cynodon dactylon) and the other two groups with coast cross pasture and grains. At the end of the fasting periods, the groups received 1g of glucose/kg of body weight in a 20% solution through a nasogastric tube. Blood samples were collected immediately before and 70, 60, 120, 180, 240, 300, and 360 minutes after glucose administration. Glycemia was determined by the orthotoluidine method and insulin by radioimmunoassay. The animals which received grains showed larger increase in glycemia and insulinemia than those maintained on pasture regimen alone. The 48-hour fasting period induced higher glycemia and insulinemia levels than those observed after 24-hour fasting.

Subclinical abnormalities of glucose metabolism in Brazilian women with a history of gestational diabetes mellitus

Background. To evaluate insulin release and insulin sensitivity in women with prior gestational diabetes mellitus (GDM) to gain a better understanding of type 2 diabetes pathogenesis.Methods. GDM women were individually matched for age, body mass index, and waist/hip ratio with those who were normal glucose tolerant in a previous pregnancy (NGT). All women presented with normal glucose tolerance. Twenty pairs were submitted to the oral glucose tolerance test (OGTT) with plasma glucose, insulin, and C-peptide determinations. of the 20 pairs, 18 participated in hyperglycemic (10.0 mmol/l) clamp experiments with frequent plasma glucose and insulin determinations, allowing us to calculate first- and second-phase insulin release and the insulin sensitivity index. GDM and NGT women were compared using Student's t-test, the Mann-Whitney U-test, Friedman's non-parametric test, and the two proportion test for independent groups.Results. GDM women showed higher glycosylated hemoglobin values; at OGTT, they showed late insulin peak with increased plasma insulin levels only during the second hour, and a similar plasma C-peptide response despite a higher plasma glucose curve; during hyperglycemic clamp procedures, they showed similar biphasic insulin release and insulin sensitivity index. Considering that a woman with previous GDM had a defect in insulin release and/or insulin sensitivity, if its magnitude was at least 25% lower than that of the matched NGT woman, 43.8% showed impairment of first-phase insulin release and 55.6% insulin resistance.Conclusions. GDM women showed some degree of glucose intolerance. It is therefore necessary to follow them for a longer time.

DIABETES AND EXPERIMENTAL PREGNANCY IN RATS - COURSE OF MATERNAL BLOOD-GLUCOSE LEVELS AND ITS REPERCUSSIONS ON THE BLOOD-GLUCOSE LEVELS AND PANCREAS OF NEWBORN PUPS

The objective of the present investigation was to determine the course of maternal blood glucose levels in pregnant rats and its repercussions on the glucose levels and pancreas of their newborn pups. Diabetes was induced by alloxan (42 mg/kg body weight) and streptozotocin (40 mg/kg). Sixty-two pregnant Wistar rats weighing 180 to 250 g were divided into a control group and two groups with moderate (120 to 200 mg/dl glucose) and severe diabetes (greater than 200 mg/dl glucose), respectively. Blood glucose levels were measured in the dams on the 1st, 14th, and 21st days of pregnancy and in the pups at birth. The results were pooled for each litter. The fetal pancreases were removed after cesarian section performed on the 21st day of pregnancy, pooled for each litter and processed for histopathologic examination by light microscopy. Maternal blood glucose levels were significantly increased compared with the first day of pregnancy in both normal and diabetic rats starting on the 14th day of pregnancy. Fetal blood glucose levels correlated with maternal levels. The histopathologic changes characterized by vacuolization and basophilia of the cytoplasm of endocrine pancreas of newborn pups from darns with moderate or severe diabetes suggested pancreatic hyperactivity.

Glucose- and insulin-induced phosphorylation of the insulin receptor and its primary substrates IRS-1 and IRS-2 in rat pancreatic islets

The presence of tyrosine-phosphorylated proteins was studied in cultured rat pancreatic islets, Immunoblotting performed with total extracts of islets cultured in the presence of 1.8 or 5.6 mM glucose revealed at least three distinct tyrosine-phosphorylated bands (25 kDa, 95 kDa and 165-185 kDa). After 12 h incubation in medium containing 1.8 mM glucose, a pulse exposition to 11 or 22 mM glucose or to 10(-7) M insulin led to a substantial increase in the phosphorylation of all three bands, with no appearance of novel bands. Immunoprecipitation with specific antibodies demonstrated that the signal detected at 95 kDa corresponds to the beta subunit of the insulin receptor (IR) while the band at 165-185 kDa corresponds to the early substrates of the insulin receptor, IRS-1 and IRS-2. Immunoprecipitation with IRS-I or IRS-2 antisera detected their association with the lipid metabolizing enzyme phosphatidylinositol 3-kinase (PI 3-kinase), Thus, this is the first demonstration that elements involved in the insulin-signalling pathway of traditional target tissues are also present in pancreatic islets and are potentially involved in auto- and paracrine-signalling in this organ.

Protein deficiency during pregnancy and lactation impairs glucose-induced insulin secretion but increases the sensitivity to insulin in weaned rats

We studied glucose homeostasis in rat pups from darns fed on a normal-protein (170 g/kg) (NP) diet or a diet containing 60 g protein/kg (LP) during fetal life and the suckling period. At birth, total serum protein, serum albumin and serum insulin levels were similar in both groups. However, body weight and serum glucose levels in LP rats were lower than those in NP rats. At the end of the suckling period (28 d of age), total serum protein, serum albumin and serum insulin were significantly lower and the liver glycogen and serum free fatty acid levels were significantly higher in LP rats compared with NP rats. Although the fasting serum glucose level was similar in both groups, the area under the blood glucose concentration curve after a glucose load was higher for NP rats (859 (SEM 58) mmol/l per 120 min for NP rats v. 607 (SEM 52) mmol/l per 120 min for LP rats; P < 0.005). The mean post-glucose increase in insulin was higher for NP rats (30 (SEM 4.7) nmol/l per 120 min for NP rats v. 17 (SEM 3.9) nnol/l per 120 min for LP rats; P < 0.05). The glucose disappearance rate for NP rats(0.7 (SEM 0.1) %/min) was lower than that for LP rats (1.6 (SEM 0.2) %/min; P < 0.001). Insulin secretion from isolated islets (1 h incubation) in response to 16.7 mmol glucose/l was augmented 14-fold in NP rats but only 2.6-fold in LP rats compared with the respective basal secretion (2.8 mmol/l; P <0.001). These results indicate that in vivo as well as in vitro insulin secretion in pups from dams maintained on a LP diet is reduced. This defect may be counteracted by an increase in the sensitivity of target tissues to insulin.

Glucose reactivity with filling materials as a limitation for using the glucose leakage model

Aim To evaluate the reactivity of different endodontic materials and sealers with glucose and to asses the reliability of the glucose leakage model in measuring penetration of glucose through these materials.Methodology Ten uniform discs (radius 5 mm, thickness 2 mm) were made of each of the following materials: Portland cement, MTA (grey and white), sealer 26, calcium sulphate, calcium hydroxide [Ca(OH)(2)], AH26,Epiphany, Resilon, gutta-percha and dentine. After storing the discs for 1 week at 37 degrees C and humid conditions, they were immersed in 0.2 mg mL(-1) glucose solution in a test tube. The concentration of glucose was evaluated using an enzymatic reaction after 1 week. Statistical analysis was performed with the ANOVA and Dunnett tests at a significant level of P < 0.05.Results Portland cement, MTA, Ca(OH)(2) and sealer 26 reduced the concentration in the test tube of glucose significantly after 1 week (P < 0.05). Calcium sulphate reduced the concentration of glucose, but the difference in concentrations was not significant (P = 0.054).Conclusions Portland cement, MTA, Ca(OH)(2) and sealer 26 react with a 0.2 mg mL(-1) glucose solution. Therefore, these materials should not be evaluated for sealing ability with the glucose leakage model.

Long-term nutrition education reduces several risk factors for type 2 diabetes mellitus in Brazilians with impaired glucose tolerance

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

The carpal pad as an alternative sampling site for blood glucose testing in dogs

To investigate the feasibility and validity of sampling blood from the carpal pad in hospitalised healthy and diabetic dogs. METHODS The carpal pad was compared to the ear as a sampling site in 60 dogs (30 healthy and 30 diabetic dogs). RESULTS Lancing the pads was very well tolerated. The average glucose concentrations in blood samples obtained from the ears and carpal pads exhibited a strong positive correlation (r = 0.938) and there were no significant differences between them (P = 0.914). In addition, 98.3% of the values obtained were clinically acceptable when assessed by the error grid analysis. CLINICAL SIGNIFICANCE The carpal pad is a good alternative sampling site for home monitoring, especially in animals with a soft and/or light-coloured pad.