Metabolic Response of Slowly Absorbed Carbohydrates in Type 2 Diabetes Mellitus

149 Pages·2016·3.86 MB·English

by  Meidjie Ang (auth.)

SPRINGER BRIEFS IN SYSTEMS BIOLOGY
Meidjie Ang
Metabolic
Response of
Slowly Absorbed
Carbohydrates in
Type 2 Diabetes
Mellitus
123
SpringerBriefs in Systems Biology
Moreinformationaboutthisseriesathttp://www.springer.com/series/10426

Meidjie Ang
Metabolic Response
of Slowly Absorbed
Carbohydrates in Type
2 Diabetes Mellitus
123
MeidjieAng
JustusLiebigUniversityGiessen
Giessen,Germany
E-mail:[email protected]
ThisworkwascarriedoutattheClinicalResearchUnitofMedicalClinicandPoliclinic3
andacceptedasdoctoralthesisattheFacultyofAgriculturalSciences,NutritionalSciences,
andEnvironmentalManagementoftheJustusLiebigUniversityGiessen.
ISSN2193-4746 ISSN2193-4754 (electronic)
SpringerBriefsinSystemsBiology
ISBN978-3-319-27897-1 ISBN978-3-319-27898-8 (eBook)
DOI10.1007/978-3-319-27898-8
LibraryofCongressControlNumber:2015959481
SpringerChamHeidelbergNewYorkDordrechtLondon
©TheAuthor2016
Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpartof
thematerialisconcerned,specificallytherightsoftranslation,reprinting,reuseofillustrations,recitation,
broadcasting,reproductiononmicrofilmsorinanyotherphysicalway,andtransmissionorinformation
storageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilarmethodology
nowknownorhereafterdeveloped.
Theuseofgeneraldescriptivenames,registerednames,trademarks,servicemarks,etc.inthispublication
doesnotimply,evenintheabsenceofaspecificstatement,thatsuchnamesareexemptfromtherelevant
protectivelawsandregulationsandthereforefreeforgeneraluse.
Thepublisher,theauthorsandtheeditorsaresafetoassumethattheadviceandinformationinthisbook
arebelievedtobetrueandaccurateatthedateofpublication.Neitherthepublishernortheauthorsor
theeditorsgiveawarranty,expressorimplied,withrespecttothematerialcontainedhereinorforany
errorsoromissionsthatmayhavebeenmade.
Printedonacid-freepaper
SpringerInternational PublishingAGSwitzerlandispartofSpringerScience+Business Media(www.
springer.com)
To Ronnyandmy family

Preface
This book focuses on relevant topic in clinical nutrition research, particularly on
the effects of slowly absorbed carbohydrateson postprandial glucose metabolism
in type 2 diabetes. Slowly absorbedcarbohydrateswill cause gradualincreases in
bloodglucoseandinsulinlevelsandmaythereforebeeffectiveaspartofatreatment
strategyforglycemiccontrolandreductionofcardiovascularcomplicationsintype
2diabetes.
Twoclinicalstudieswithrandomized,double-blinded,andcrossoverdesignare
presentedindetailinthisbook.Thefirststudycharacterizedmetabolicpathwayof
thedisaccharideslowlydigestedisomaltuloseasopposedtorapidlydigestedsucrose
usingadoubleisotopetechnique,whichcombinesahyperinsulinemic-euglycemic
clamp with an oral load of the disaccharides. This method enables assessment of
glucoseabsorption,postprandialglucoseturnover,and insulinsensitivity by using
mathematical models, such as the one- and two-compartment models of glucose
kineticsaswellastheoralglucoseminimalmodelofinsulinactionintype2diabetic
patients.Thesecondstudyassessedpostprandialglucoseandinsulinresponsesafter
oraladministrationofisomaltulosealoneorincombinationwithproteinsintype2
diabetic patients. The results of these studies provide novel insight on the effects
of slowly absorbed carbohydrates on postprandial glucose homeostasis in type 2
diabetes.
Thekeyfeaturesofthisbookare:
• It provides an up-to-date systematic review on the effects of slowly absorbed
isomaltulose on postprandialglucose metabolismin humans, includinghealthy
probands,impairedglucose-tolerantsubjects,andbothtype1andtype2diabetic
patients
• Itexaminesthemetabolicresponseofslowlyabsorbedisomaltulosecomparedto
rapidlyabsorbedsucrosecomprehensivelyintype2diabeticpatients
• It gives an extensive description of the assessment methods and a detailed
calculationprocedureofglucosekineticsandinsulinaction
• It highlights new evidence on the role of slowly absorbed carbohydrates for
glycemiccontrolintype2diabetes
vii
viii Preface
This book is intended for both the general reader and the specialist, including
nutritional scientists, academics or researchers interested in nutrition and clinical
nutrition, endocrinologists, diet or diabetes advisors, nutritionists, public health
scientists or healthcare providers who are interested in health promotion and
prevention of diabetes diseases, and students searching for detail information on
theapplicationofstableisotopesinaclinicalsetting.
September2015 MeidjieAng
Acknowledgments
Thisbookisahardworkofmanyyears.Itwouldnothavebeenpossiblewithoutthe
encouragement,support,andcontributionfromalotofpeople.Firstandforemost,I
thankmysupervisorProf.Dr.ThomasLinnforgivingmetheopportunitytoworkin
thechallengingareaofglucosehomeostasisindiabetesmellitus.Iappreciateallhis
contributionsoftime,ideas,andfruitfuldiscussiontowardthisbook.Hehasshowed
me directly and indirectly how to manage clinical research studies and taught me
about patience and persistence when I hit a bottleneck during the time period of
pursuingmydoctoraldegree.Hissuggestions,attention,andpromptresponseswere
agreatdealtomywork.Iamalso gratefultoProf.Dr. MichaelKrawinkelforhis
timetoreviewthedraftofmybookandgivevaluableinputs.
My sincere gratitudeis extendedto the past and presentgroupmembersof the
ClinicalResearchUnit(CRU),especiallySinaStreichertandJuttaSitte,fortaking
care of the patients and for their technical assistance in performing the studies. I
also thank Jutta Schmidt for her support in measuring glucagonin blood samples
andDorisErbforthe guidancethroughthe laboratoryduringmyearly stayin the
Medical Clinic and Policlinic 3. I am also indebtedto all the people who were in
chargeofadditionalbloodsamples.
Inregardtothestableisotopeprobes,IacknowledgethesupportofDr.Christian
BorschfromtheAnalyticalPlatformofStableIsotopeandCellBiology(Director:
Prof.Dr.ClemensKunz)inanalyzingthepreliminarystable isotopederivativesin
blood and breath samples. Additional analyses were performed at the laboratory
of the Clinical Research Center of the University of Rochester. I would also like
tothanktheNumicoResearch forcontributingwith theaminoaciddataandProf.
Richard Bergman at the Cedars-Sinai Diabetes and Obesity Research Institute for
providingtheOOPSEGprogram.Further,IexpressmysincereappreciationtoDr.
ManfredHollenhorstforintroducingSPSStomemanyyearsago.
MytimeatCRUwasalsoenrichedbytheGiessenGraduateCentrefortheLife
Sciences.Ithankmyfellowgraduatestudents,Neelam,Chunguang,andBalaji,for
sharingtheirexperiencesandopinionswithme.ForthisbookIthankRonnyandmy
brothersHusenandTonnyfortheirtime,interest,andhelpfulcommentsinreading
andeditingthedraft.
ix