Effect of Insulin and Energy Restriction on the Thermic Effect of Protein in Type 2 Diabetes Mellitus
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Résumé
OBJECTIVE: The objective of this study was to test whether the thermic effect of oral protein is blunted in poorly controlled type 2 diabetes and is corrected by normalization of glycemia with insulin and 28 days of a very-low-energy diet. RESEARCH METHODS AND PROCEDURES: Resting energy expenditure (REE) and the thermic effect of 90 g of oral protein were measured, using indirect calorimetry, in nine (five women and four men) obese diabetic people [weight, 108 +/- 10 kg; waist circumference, 123 +/- 8 cm; body mass index, 40 +/- 3 kg/m(2)] who were hyperglycemic on day 8 or euglycemic with insulin on day 16 of a weight-maintaining diet and euglycemic on day 28 of a very low energy diet (VLED). Results were compared with those of seven (six women and one man) weight- and body mass index-matched obese nondiabetic subjects with a waist circumference of 111 +/- 6 cm. Substrates and hormonal responses were determined concurrently. RESULTS: Fasting glucose was normalized in the diabetic subjects with insulin from day 9 of VLED onward. Weight decreased in both groups by 9.9 +/- 0.9 kg with VLED. REE was 8 +/- 2% lower with insulin treatment and decreased by another 14 +/- 3% with VLED in the diabetic and by 15 +/- 1% in the nondiabetic subjects by week 4. After the protein meal, the thermic response was significantly (p < 0.05) less with hyperglycemia than with insulin-induced euglycemia, as percentage above REE (15.3 +/- 1.4 compared with 21.2 +/- 1.5%), as percentage of the energy content of the meal (19.5 +/- 1.5 compared with 25.2 +/- 1.7%), as kilocalories per 405 minutes (86 +/- 5 compared with 110 +/- 7), and less than in nondiabetic obese controls (21.0 +/- 2.2% above REE, 24.4 +/- 1.7% of energy of meal). After the VLED, the thermic effect of protein was significantly higher in both groups only as percentage above REE. The initial glucagon response was greater with hyperglycemia compared with euglycemia and post-VLED but not compared with the nondiabetic subjects. Hyperglycemia was associated with 21 +/- 4% greater urinary urea nitrogen excretion and urinary glucose losses of 134 +/- 50 mmol/d. DISCUSSION: This study shows a blunted thermic effect of protein in obese hyperglycemic type 2 diabetic subjects compared with matched nondiabetic subjects that can be corrected with insulin- or energy restriction-induced euglycemia.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle