Dietary habits and diabetes mellitus - with special reference to carbohydrate in take

1)我们的研究表明，在口服葡萄糖饮食之前，高脂肪/低碳水化合物饮食会损害人类和大鼠的葡萄糖耐量。为了确定哪种营养素是导致低碳水化合物/低脂饮食引起的葡萄糖耐受不良的原因，我们评估了过夜禁食对葡萄糖耐量的影响。工作假设是，如果空腹损害葡萄糖耐量，减少的成分（碳水化合物）将比增加的成分（脂肪）更负责由高脂肪/低碳水化合物饮食引起的葡萄糖耐量损害。低碳水化合物/高脂肪饮食对葡萄糖耐量的损害程度与整夜禁食几乎相同。这一发现表明，碳水化合物摄入量的减少比脂肪摄入量的增加更容易导致高脂肪/低碳水化合物饮食引起的葡萄糖耐量受损。 ...更多信息 碳水化合物的摄入总是伴随着空腹血浆中游离脂肪酸（FFA）水平的增加。我们用包括大鼠胰岛的灌流系统证明，低碳水化合物饮食抑制胰岛中β细胞对葡萄糖的反应分泌胰岛素，FFA输注抑制正常喂养大鼠胰岛的胰岛素分泌。这表明这种损害与Randle效应有关，Randle效应是无葡萄糖脂肪酸循环的激活。3）在一项正在进行的临床试验中，7名糖尿病患者接受高碳水化合物饮食（80%碳水化合物，5%脂肪和15%蛋白质）或对照饮食（60%碳水化合物，25%脂肪和15%蛋白质）交叉设计各一周，证实高碳水化合物饮食改善轻度糖尿病患者的糖耐量.从这些观察，我们得出结论，长期摄入低碳水化合物饮食是决定糖尿病发病的因素，在个人的疾病易感性。少

1) Our research demonstrated that a high-fat/low-carbohydrate diet before an oral glucose diet impairs glucose tolerance both in humans and rats. In order to determine which nutrient is responsible for the glucose intolerance caused by a low-carbohydrate/low-fat diet, we assessed the effect of overnight fasting on glucose tolerance. The working hypothesis was that if fasting impairs glucose tolerance, the decreased component (carbohydrate) would be more responsible than the increased component (fat) for the impairment of glucose tolerance caused by a high-fat/low-carbohydrate diet. The degree of glucose tolerance impairment by a low-carbohydrate/high-fat diet was almost the same as that resulting from overnight fasting. This finding establishes that the decreased intake of carbohydrate is more responsible than the increased intake of fat for the impairment of glucose tolerance that is caused by a high-fat/low-carbohydrate diet.2) The impairment of glucose tolerance after restricted car … More bohydrate intake was invariably accompanied by an increase in free fatty acid (FFA) level in the fasting plasma. With a perifusion system including pancreatic islets of Langerhans from rats, we demonstrated that a low-carbohydrate diet inhibits the secretion of insulin by β-cells in the islets in response to glucose and that FFA infusion inhibits the insulin secretion of Langerhans islets from normally fed rats. This suggests that the impairment is associated with the Randle effect, which is the activation of the glucose-free fatty acid cycle.3) In an ongoing clinical trial, where 7 diabetic patients were placed on a high-carbohydrate diet (80% carbohydrate, 5% fat and 15% protein) or a control diet (60% carbohydrate, 25% fat and 15% protein) for one week each in a crossover design, we confirmed that the high-carbohydrate diet improves the glucose tolerance in mildly diabetic patients.4. From these observations, we conclude that the long-term ingestion of a low-carbohydrate diet is the factor determining the onset of diabetes mellitus in individuals with a predisposition to the disease. Less