ࡱ > X Z W @ X bjbjʚʚ +\ * , 8 (
, T
l , k &
L $ R
9
% : : :
( J | :
: : :
S% : ; 0 k : v : , , : | > U , : $ , , " , , Table A1: Volunteer Characteristics at screening:
DiabeticNon-diabeticAge (yrs)57.33534Weight (kg)905826FFM (kg)543475BMI (kg/m2)31.22292% body fat (%)373383Total abdominal fat (cm2)429.35234367Visceral fat (cm2)201.333*111.729Fasting glucose (mM)8.20.4*5.30.2HbA1c (%)6.80.3*5.50.1Diabetes duration (yrs)6.51.2N/ADiabetes therapy2 on diet; 7 metformin;
5 metformin + glipizideN/ABMI: Body Mass Index. FFM: Fat Free Mass. TAF: Total Abdominal Fat. VF: Visceral Fat; FPG: Fasting Plasma Glucose obtained during screening visit. * denotes significance with p<0.05 vs. non-diabetic subjects.
Calculation of Meal indices:
Indices of net insulin action (Si), glucose effectiveness (Sg) and of the ability of insulin (Si*) and glucose (Sg*) to stimulate glucose disposal were calculated using the oral minimal model as previously described ADDIN EN.CITE Basu2003355603556128296415272003JulMechanisms of the age-associated deterioration in glucose tolerance: contribution of alterations in insulin secretion, action, and clearance1738-48Endocrine Research Unit, Mayo Medical School, Rochester, Minnesota, USA.Basu, R.Breda, E.Oberg, A. L.Powell, C. C.Dalla Man, C.Basu, A.Vittone, J. L.Klee, G. G.Arora, P.Jensen, M. D.Toffolo, G.Cobelli, C.Rizza, R. A.DiabetesAdultAgedAging/*physiologyBlood Glucose/*metabolismBody Mass IndexC-Peptide/bloodDehydroepiandrosterone Sulfate/bloodEating/physiologyFatty Acids, Nonesterified/bloodGlucagon/bloodGlucose/pharmacologyGlucose Tolerance TestHuman Growth Hormone/bloodHumansHydrocortisone/bloodInsulin/*blood/*secretionPalmitic Acid/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12829641Basu2006355003550168040695572006JulEffects of age and sex on postprandial glucose metabolism: differences in glucose turnover, insulin secretion, insulin action, and hepatic insulin extraction2001-14Mayo Clinic College of Medicine, 200 1st St. SW, Rm. 5-194 Joseph, Rochester, MN 55905, USA.Basu, R.Dalla Man, C.Campioni, M.Basu, A.Klee, G.Toffolo, G.Cobelli, C.Rizza, R. A.DiabetesAdultAge FactorsAgedBlood Glucose/*metabolismC-Peptide/bloodCarbon IsotopesFemaleHumansInsulin/blood/isolation & purification/*secretionIsotope LabelingKineticsLiver/*physiologyMaleSex Characteristicshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16804069Dalla Man20053567035671597226928952005NovMeasurement of selective effect of insulin on glucose disposal from labeled glucose oral test minimal modelE909-14Dept. of Information Engineering, Univ. of Padova, Via Gradenigo 6/B, I-35131 Padua, Italy.Dalla Man, C.Caumo, A.Basu, R.Rizza, R.Toffolo, G.Cobelli, C.Am J Physiol Endocrinol MetabAdultAgedAged, 80 and overBlood Glucose/*metabolismCarbon IsotopesDeuteriumFemaleGlucose Tolerance Test/*methodsHumansInsulin/*bloodMaleMiddle Aged*Models, BiologicalTritiumhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15972269(1-3). Estimation of Si in most individuals with type 2 diabetes, particularly in those who are very insulin resistant, is difficult due to poor precision. Since Sg is well estimated in all subjects, to improve numerical accuracy of the model we used the constraints Sg=(GEZI+SI Ib)/V (GEZI: glucose effectiveness at zero insulin; Ib: basal insulin concentration; V: volume), to link Si to Sg through parameter GEZI. In all these subjects, a Bayesian parameter estimation was employed by assuming GEZI to be normally distributed with mean=0.025 dl/kg/min and CV=10%. This value was the average of GEZI in those subjects in whom the model was successfully identified by weighted nonlinear least squares. However, the sensitivity of the estimates to the prior average was low, e.g. GEZI converged to very similar values using a mean estimate of 0.036, the average GEZI in normal subjects ADDIN EN.CITE Basu2006355003550168040695572006JulEffects of age and sex on postprandial glucose metabolism: differences in glucose turnover, insulin secretion, insulin action, and hepatic insulin extraction2001-14Mayo Clinic College of Medicine, 200 1st St. SW, Rm. 5-194 Joseph, Rochester, MN 55905, USA.Basu, R.Dalla Man, C.Campioni, M.Basu, A.Klee, G.Toffolo, G.Cobelli, C.Rizza, R. A.DiabetesAdultAge FactorsAgedBlood Glucose/*metabolismC-Peptide/bloodCarbon IsotopesFemaleHumansInsulin/blood/isolation & purification/*secretionIsotope LabelingKineticsLiver/*physiologyMaleSex Characteristicshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16804069(2). A similar approach was used to estimate Si* (GEZI* was assumed to be normally distributed with mean=0.0125 dl/kg/min and CV=10%). Indices of insulin secretion including Ft o t a l ( t o t a l r e s p o n s e t o t h e g l y c e m i c s t i m u l i ) , Fd y n a m i c ( r e s p o n s e t o a c h a n g e i n g l u c o s e c o n c e n t r a t i o n ) , a n d Fs t a t i c ( r e s p o n s e t o a g i v e n g l u c o s e c o n c e n t r a t i o n ) w e r e c a l c u l a t e d u s i n g t h e o r a l C - p e p t i d e s e c r e t i o n m o d e l a s p r e v i o u s l y d e s c r i b e d A D D I N E N . C ITE Basu2006355003550168040695572006JulEffects of age and sex on postprandial glucose metabolism: differences in glucose turnover, insulin secretion, insulin action, and hepatic insulin extraction2001-14Mayo Clinic College of Medicine, 200 1st St. SW, Rm. 5-194 Joseph, Rochester, MN 55905, USA.Basu, R.Dalla Man, C.Campioni, M.Basu, A.Klee, G.Toffolo, G.Cobelli, C.Rizza, R. A.DiabetesAdultAge FactorsAgedBlood Glucose/*metabolismC-Peptide/bloodCarbon IsotopesFemaleHumansInsulin/blood/isolation & purification/*secretionIsotope LabelingKineticsLiver/*physiologyMaleSex Characteristicshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16804069(2). Disposition indices (DI) were calculated by multiplying indices of insulin secretion times indices of insulin action in order to determine whether insulin secretion was appropriate for the degree of insulin resistance.
References:
ADDIN EN.REFLIST 1. Basu R, Breda E, Oberg AL, Powell CC, Dalla Man C, Basu A, Vittone JL, Klee GG, Arora P, Jensen MD, Toffolo G, Cobelli C, Rizza RA: Mechanisms of the age-associated deterioration in glucose tolerance: contribution of alterations in insulin secretion, action, and clearance. Diabetes 52:1738-1748, 2003
2. Basu R, Dalla Man C, Campioni M, Basu A, Klee G, Toffolo G, Cobelli C, Rizza RA: Effects of age and sex on postprandial glucose metabolism: differences in glucose turnover, insulin secretion, insulin action, and hepatic insulin extraction. Diabetes 55:2001-2014, 2006
3. Dalla Man C, Caumo A, Basu R, Rizza R, Toffolo G, Cobelli C: Measurement of selective effect of insulin on glucose disposal from labeled glucose oral test minimal model. Am J Physiol Endocrinol Metab 289:E909-914, 2005
Basu et al 2 3
DzziS> (hU( hT CJ OJ QJ ^J aJ mH sH +hU( h[ 5CJ OJ QJ ^J aJ mH sH !hT 5CJ OJ QJ aJ mH sH (hU( hT CJ OJ QJ ^J aJ mHsH #hU( hT CJ H*OJ QJ ^J aJ hU( hT CJ OJ QJ ^J aJ (hU( hT CJ OJ QJ ^J aJ mH sH $hU( hT CJ OJ QJ ^J mH sH !hfqh 5CJ OJ QJ ^J mH sH 'hU( hT 5CJ OJ QJ ^J mH sH 2 3 < I J T [ ` L kd $$If T l F <
t 0 4
l a T $d $If a$gdT d $If gdT $a$gdT 3 X ` a m r w s e T T $d $If a$gdT d $If gdT kd $$If T l F <
t 0 4
l a T w x s e T T $d $If a$gdT d $If gdT kdH $$If T l F <
t 0 4
l a T s e T T $d $If a$gdT d $If gdT kd $$If T l F <
t 0 4
l a T s e T T $d $If a$gdT d $If gdT kd $$If T l F <
t 0 4
l a T s e T T $d $If a$gdT d $If gdT kd4 $$If T l F <
t 0 4
l a T s e T T $d $If a$gdT d $If gdT kd $$If T l F <
t 0 4
l a T & / 7 s e T T $d $If a$gdT d $If gdT kd| $$If T l F <
t 0 4
l a T 7 8 B K S s e T T $d $If a$gdT d $If gdT kd $$If T l F <
t 0 4
l a T S T l t x s e T T $d $If a$gdT d $If gdT kd $$If T l F <
t 0 4
l a T x y s e T T T $d $If a$gdT d $If gdT kdh $$If T l F <
t 0 4
l a T
0 0 0 s a N N N N N $d 1$ 7$ 8$ H$ a$gdT 0d ^`0gdT kd $$If T l F <
t 0 4
l a T
! # / 1 j r ~i (hU( h CJ OJ QJ ^J aJ mH sH (hU( h,pJ CJ OJ QJ ^J aJ mH sH (hU( hml CJ OJ QJ ^J aJ mH sH 1j hU( h[ CJ OJ QJ U^J aJ mH sH (hU( h[ CJ OJ QJ ^J aJ mH sH (hU( h CJ OJ QJ ^J aJ mH sH (hU( h4 CJ OJ QJ ^J aJ mH sH ) , ' + 3 4 = > C D J ! ! ! &