Adaptation of β-Cell and Endothelial Function to Carbohydrate Loading: Influence of Insulin Resistance

Diabetes
Barry E HurwitzEle Ferrannini

Abstract

High-carbohydrate diets have been associated with β-cell strain, dyslipidemia, and endothelial dysfunction. We examined how β-cell and endothelial function adapt to carbohydrate overloading and the influence of insulin resistance. On sequential days in randomized order, nondiabetic subjects (classified as insulin-sensitive [IS] [n = 64] or insulin-resistant [IR] [n = 79] by euglycemic clamp) received four mixed meals over 14 h with either standard (300 kcal) or double carbohydrate content. β-Cell function was reconstructed by mathematical modeling; brachial artery flow-mediated dilation (FMD) was measured before and after each meal. Compared with IS, IR subjects showed higher glycemia and insulin hypersecretion due to greater β-cell glucose and rate sensitivity; potentiation of insulin secretion, however, was impaired. Circulating free fatty acids (FFAs) were less suppressed in IR than IS subjects. Baseline FMD was reduced in IR, and postprandial FMD attenuation occurred after each meal, particularly with high carbohydrate, similarly in IR and IS. Throughout the two study days, higher FFA levels were significantly associated with lower (incretin-induced) potentiation and impaired FMD. In nondiabetic individuals, enhanced glucos...Continue Reading

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Citations

Nov 4, 2017·Clinical Science·Eleni RebelosEle Ferrannini
Oct 1, 2015·The British Journal of Nutrition·Yean Yean SoongChristiani Jeyakumar Henry

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Methods Mentioned

BETA
blood draws

Software Mentioned

LabVIEW
SPSS

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