METABOLIC EFFECTS OF REDUCING RATE OF GLUCOSE-INGESTION BY SINGLE BOLUS VERSUS CONTINUOUS SIPPING
METABOLIC EFFECTS OF REDUCING RATE OF GLUCOSE-INGESTION BY SINGLE BOLUS VERSUS CONTINUOUS SIPPING
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DOI：
10.2337/diabetes.39.7.775
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发表时间：
1990-07-01
期刊：
影响因子：
7.7
通讯作者：
JOSSE, RG
中科院分区：
文献类型：
--
作者：
JENKINS, DJA;WOLEVER, TMS;JOSSE, RG
改变吸收率已被提出作为一种与糖尿病具体相关的治疗原则。为了清楚地证明降低营养输送速率可能带来的代谢益处，9名健康志愿者分两次在700毫升水中服用50克葡萄糖：超过5-10分钟（大剂量）和在3.5小时内以恒定速率（小口）。尽管4小时血糖区相似，但血清胰岛素显著降低（54 .+-）。10%, P < 0.001)和c -肽（47.1%）。12%, P < 0.01)，同时胃抑制多肽和肠胰高血糖素水平降低，尿儿茶酚胺含量降低。抿饮后，血浆胰高血糖素、生长激素和游离脂肪酸（FFA）水平也有较长时间的抑制，而这些水平在葡萄糖丸后3-4小时上升。4小时静脉葡萄糖耐量试验显示为48 +-。小饮后血糖（Kg）下降速度比大丸后快10% （P < 0.01）。此外，在此期间，尽管胰岛素和c肽的绝对水平相似，但FAA和总支链氨基酸水平作为胰岛素作用的额外标记物较低。这些发现表明，延长葡萄糖吸收速率可以提高胰岛素经济性和葡萄糖处理。
Modifying the rate of absorption has been proposed as a therapeutic principle of specific relevance to diabetes. To demonstrate clearly the metabolic benefits that might result from reducing the rate of nutrient delivery, nine healthy volunteers took 50 g glucose in 700 ml water on two occasions: over 5-10 min (bolus) and at a constant rate over 3.5 h (sipping). Despite similar 4-h blood glucose areas, large reductions were seen in serum insulin (54 .+-. 10%, P < 0.001) and C-peptide (47 .+-. 12%, P < 0.01) areas after sipping, together with lower gastric inhibitory polypeptide and enteroglucagon levels and urinary catecholamine output. There was also prolonged suppression of plasma glucagon, growth hormone, and free-fatty acid (FFA) levels after sipping, whereas these levels rose 3-4 h after the glucose bolus. An intravenous glucose tolerance test at 4 h demonstrated at 48 .+-. 10% (P < 0.01) more rapid decline in blood glucose (Kg) after sipping than after the bolus. Furthermore, FAA and total branched-chain amino acid levels as additional markers of insulin action were lower over this period despite similar absolute levels of insulin and C-peptide. These findings indicate that prolonging the rate of glucose absorption enhances insulin economy and glucose disposal.