Relationships between metabolic clearance rate of insulin and body mass index in a female population ranging from anorexia nervosa to severe obesity.
; Scheen, André ; Jandrain, Bernard et al
in International Journal of Obesity & Related Metabolic Disorders (1994), 18(1), 47-53
Changes in the metabolic clearance rate of insulin (MCRI) have been described in several pathological conditions. Conflicting data suggest that they may be related to either body mass index (BMI) or body ... [more ▼]
Changes in the metabolic clearance rate of insulin (MCRI) have been described in several pathological conditions. Conflicting data suggest that they may be related to either body mass index (BMI) or body composition. This study aimed to investigate the relationship between the MCRI and BMI in an exclusively female population showing a wide range of BMI. For that purpose, hyperinsulinemic normoglycemic glucose clamps were performed in nine anorectic subjects (BMI: 14.5 +/- 0.8 kg/m2), 11 healthy volunteers (BMI: 20.3 +/- 0.5 kg/m2) and 12 obese patients (BMI: 33.0 +/- 0.9 kg/m2). To exclude any influence of the menstrual cycle on the MCRI, five healthy women underwent three tests at different days of the menstrual cycle: menstruation period, late follicular pre-ovulatory phase and luteal phase, in random order. The MCRI, which was quite reproducible in a given subject, was not significantly modified by the menstrual cycle. In the premenopausal female population studied, the mean (+/- s.e.m.) MCRI normalized for body weight (kg) were 35.4 +/- 3.4, 24.7 +/- 1.8 and 14.0 +/- 1.0 ml/kg/min (P < 0.01) for anorectic subjects, healthy volunteers and obese patients, respectively. These differences were maintained when the MCRI was normalized according to corporeal surface (m2) (1018 +/- 75, 859 +/- 67, 638 +/- 40 ml/m2/min, P < 0.01) or lean body mass (kg) (37.1 +/- 3.4, 32.6 +/- 2.7 and 24.1 +/- 0.5 ml/kgLBM/min, P < 0.01), but disappeared when MCRI was expressed per kg of ideal body weight (24.6 +/- 2.2, 24.6 +/- 2.1 and 22.4 +/- 1.4 ml/kgIBW/min, n.s.).(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]Detailed reference viewed: 61 (1 ULg)
Endogenous substrate oxidation during exercise and variations in breath 13CO2/12CO2.
; Pirnay, Freddy ; Jandrain, Bernard et al
in Journal of Applied Physiology (Bethesda, Md. : 1985) (1993), 74(1), 133-8
This study attempted to induce a major shift in the utilization of endogenous substrates during exercise in men by the use of a potent inhibitor of adipose tissue lipolysis, Acipimox, and to see to what ... [more ▼]
This study attempted to induce a major shift in the utilization of endogenous substrates during exercise in men by the use of a potent inhibitor of adipose tissue lipolysis, Acipimox, and to see to what extent this affects the 13C/12C ratio in expired air CO2. Six healthy volunteers exercised for 3 h on a treadmill at approximately 45% of their maximum O2 uptake, 75 min after having ingested either a placebo or 250 mg Acipimox. The rise in plasma free fatty acids and glycerol was almost totally prevented by Acipimox, and no significant rise in the utilization of lipids, evaluated by indirect calorimetry, was observed. Total carbohydrate oxidation averaged 128 +/- 17 (placebo) and 182 +/- 21 g/3 h (Acipimox). Conversely, total lipid oxidation was 84 +/- 5 (placebo) and 57 +/- 6 g/3 h (Acipimox; P < 0.01). Under placebo, changes in expired air CO2 delta 13C were minimal, with only a 0.49/1000 significant rise at 30 min. In contrast, under Acipimox, the rise in expired air CO2 delta 13C averaged 1/1000 and was significant throughout the 3-h exercise bout; in these conditions calculation of a "pseudooxidation" of an exogenous sugar naturally or artificially enriched in 13C, but not ingested, would have given an erroneous value of 19.8 +/- 2.6 g/3 h. Thus under conditions of extreme changes in endogenous substrate utilization, an appropriate control experiment is mandatory when studying exogenous substrate oxidation by 13C-labeled substrates and isotope-ratio mass spectrometry measurements on expired air CO2. [less ▲]Detailed reference viewed: 31 (1 ULg)
Effects of a 1-year treatment with a low-dose combined oral contraceptive containing ethinyl estradiol and cyproterone acetate on glucose and insulin metabolism.
Scheen, André ; Jandrain, Bernard ; Humblet, Dominique et al
in Fertility and Sterility (1993), 59(4), 797-802
OBJECTIVE: To study the effects of the slightly estrogen-dominant monophasic low-dose oral contraceptive (OC) Diane-35 (Schering AG, Berlin, Germany) (35 micrograms ethinyl estradiol [EE2] + 2 mg ... [more ▼]
OBJECTIVE: To study the effects of the slightly estrogen-dominant monophasic low-dose oral contraceptive (OC) Diane-35 (Schering AG, Berlin, Germany) (35 micrograms ethinyl estradiol [EE2] + 2 mg cyproterone acetate, a 17 alpha-hydroxyprogesterone derivative [17-OHP]) on glucose and insulin metabolism. DESIGN: Seven healthy young women were investigated by using the euglycemic hyperinsulinemic glucose clamp technique (insulin delivery rate = 100 mU/kg per hour for 120 minutes). This test was performed, after an overnight fast, during the last 7 days of a spontaneous cycle and within the last 5 days of pill intake during the sixth and twelfth cycle of a continuous treatment with Diane-35 in each subject. RESULTS: The three indexes measuring the insulin-induced glucose disposal during the clamp (glucose infusion rate, glucose metabolic clearance rate, and glucose infusion rate divided by plasma insulin plateau levels) were not significantly affected by Diane-35. In contrast, the metabolic clearance rate of the exogenous insulin infused during the clamp tended to be slightly increased with Diane-35 (significant after 6 but not after 12 cycles). CONCLUSION: These results suggest that a 1-year treatment with the OC Diane-35, which contains EE2 + a 17-OHP rather than a 19-nortestosterone derivative as the progestogen compound, does not significantly alter peripheral (presumably muscular) insulin sensitivity but slightly increases insulin (presumably hepatic) clearance. [less ▲]Detailed reference viewed: 52 (0 ULg)
Fructose utilization during exercise in men: rapid conversion of ingested fructose to circulating glucose.
Jandrain, Bernard ; ; et al
in Journal of Applied Physiology (Bethesda, Md. : 1985) (1993), 74(5), 2146-54
The aim of the present study was to compare the metabolic fate of repeated doses of fructose or glucose ingested every 30 min during long-duration moderate-intensity exercise in men. Healthy volunteers ... [more ▼]
The aim of the present study was to compare the metabolic fate of repeated doses of fructose or glucose ingested every 30 min during long-duration moderate-intensity exercise in men. Healthy volunteers exercised for 3 h on a treadmill at 45% of their maximal oxygen consumption rate. "Naturally labeled" [13C]glucose or [13C]fructose was given orally at 25-g doses every 30 min (total feeding: 150 g; n = 6 in each group). Substrate utilization was evaluated by indirect calorimetry, and exogenous sugar oxidation was measured by isotope ratio mass spectrometry on expired CO2. Results were corrected for baseline drift in 13C/12C ratio in expired air due to exercise alone. Fructose conversion to plasma glucose was measured combining gas chromatography and isotope ratio mass spectrometry. Most of the ingested glucose was oxidized: 81 +/- 4 vs. 57 +/- 2 g/3 h for fructose (2P < 0.005). Exogenous glucose covered 20.8 +/- 1.4% of the total energy need (+/- 6.7 MJ) compared with 14.0 +/- 0.6% for fructose (2P < 0.005). The contribution of total carbohydrates was significantly higher and that of lipids significantly lower with glucose than with fructose. The blood glucose response was similar in both protocols. From 90 to 180 min, 55-60% of circulating glucose was derived from ingested fructose. In conclusion, when ingested repeatedly during moderate-intensity prolonged exercise, fructose is metabolically less available than glucose, despite a high rate of conversion to circulating glucose. [less ▲]Detailed reference viewed: 27 (0 ULg)
Insulin secretion and action in various populations with type 2 (non-insulin-dependant) diabetes mellitus
Scheen, André ; ; et al
in Diabetologia (1992), 16 ( suppl 1)(29), 116Detailed reference viewed: 10 (0 ULg)
Transfert des insulines U40 aux insulines U100: comparaison des profils insulinémiques et glycémiques chez le patient diabétique
; ; et al
in Revue Médicale de Liège (1991), 46(4), 181-7Detailed reference viewed: 12 (0 ULg)
Transfert des insulines U40 aux insulines U100: comparaison des profils insulinémiques et glycémiques chez des patients diabétiques de type 1 et de type 2 traités par insuline Monotard HM et Actrapid HM matin et soir.
Scheen, André ; ; JANDRAIN, Bernard et al
in Diabètes & Métabolism (1991), 17(suppl), 31Detailed reference viewed: 8 (0 ULg)
Effects of ethinyl estradiol combined with desogestrel and cyproterone acetate on glucose tolerance and insulin response to an oral glucose load: a one-year randomized, prospective, comparative trial.
Jandrain, Bernard ; Humblet, Dominique ; et al
in American Journal of Obstetrics and Gynecology (1990), 163(1 Pt 2), 378-81
To investigate the effects of two slightly estrogen-dominant, monophasic, low-dose oral contraceptives on carbohydrate metabolism, 40 healthy young women were randomly allocated to receive either 30 ... [more ▼]
To investigate the effects of two slightly estrogen-dominant, monophasic, low-dose oral contraceptives on carbohydrate metabolism, 40 healthy young women were randomly allocated to receive either 30 micrograms of ethinyl estradiol + 150 micrograms of desogestrel, a 19-nortestosterone-derived progestin (Marvelon; n = 21) or 35 micrograms of ethinyl estradiol + 2 mg of cyproterone acetate, a 17-acetoxyprogesterone derivative (Diane-35; n = (19) for a prospective observation period of 1 year. At baseline, 6, and 12 months, blood glucose, plasma insulin, and plasma C-peptide levels were measured during an oral glucose tolerance test. Although the changes were absent (Marvelon) or minimal (Diane-35) at 6 months, both groups had a slight increase in blood glucose levels at 12 months; overall glucose tolerance remaining, however, within the normal range. Plasma insulin levels remained unchanged in the Diane-35-group, which suggested increased insulin resistance, but were significantly decreased in the Marvelon group despite significant rises in plasma C-peptide levels. Comparison of plasma C-peptide and insulin changes suggests enhanced pancreatic insulin secretion and increased hepatic insulin metabolism with both Marvelon and Diane-35. [less ▲]Detailed reference viewed: 95 (2 ULg)
Alimentation avant, pendant et après l'exercice physique chez le sujet normal et diabétique
Jandrain, Bernard ; Lefèbvre, Pierre ; Pirnay, Freddy et al
in Journées Annuelles de Diabetologie de l'Hôtel-Dieu (1990)Detailed reference viewed: 91 (3 ULg)
Sandostatin, a new analogue of somatostatin, reduces the metabolic changes induced by the nocturnal interruption of continuous subcutaneous insulin infusion in type 1 (insulin-dependent) diabetic patients.
Scheen, André ; ; et al
in Diabetologia (1989), 32(11), 801-9
With the aim of assessing a new somatostatin analogue to prevent the metabolic changes induced by a 6-h nocturnal arrest of an insulin pump, nine C-peptide negative Type 1 (insulin-dependent) diabetic ... [more ▼]
With the aim of assessing a new somatostatin analogue to prevent the metabolic changes induced by a 6-h nocturnal arrest of an insulin pump, nine C-peptide negative Type 1 (insulin-dependent) diabetic patients were submitted blindly to two interruptions (from 23.00 to 05.00 hours) of their continuous s.c. insulin infusion, once after a single s.c. injection at 23.00 hours of 50 micrograms SMS 201-995 (Sandostatin, Sandoz) and once after 0.9% NaCl. Plasma SMS 201-995 levels peaked at 24.00 hours and then declined with an elimination half-life averaging 144 +/- 15 min. Plasma glucagon and growth hormone levels were significantly reduced after SMS 201-995 whereas the progressive fall in plasma-free insulin levels from 23.00 to 05.00 hours was unaffected. In the control test, blood glucose levels tended to decrease slightly from 23.00 to 02.00 hours and then increased markedly from 02.00 to 05.00 hours (+5.3 +/- 1.5 mmol/l) while after SMS 201-995 they decreased significantly from 23.00 to 02.00 hours (-2.6 +/- 0.5 mmol/l), resulting in values below 3 mmol/l in seven subjects, but showed a secondary increase until 05.00 hours (+3.5 +/- 1.5 mmol vs 23.00 h; p less than 0.05 vs 0.9% NaCl). While the rises in plasma non-esterified fatty acid and glycerol levels were not reduced by SMS 201-995, the increase in plasma 3-hydroxbutyrate levels, although similar from 23.00 to 02.00 hours, was significantly reduced from 02.00 to 05.00 hours (+77 +/- 20 vs +124 +/- 31 mumols.l-1.h-1; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]Detailed reference viewed: 34 (14 ULg)
Effect of osmolality on availability of glucose ingested during prolonged exercise in humans.
Jandrain, Bernard ; Pirnay, Freddy ; et al
in Journal of Applied Physiology (Bethesda, Md. : 1985) (1989), 67(1), 76-82
The aim of this study was to investigate whether the osmolality of a glucose solution, ingested at the beginning of a prolonged exercise bout, affects exogenous glucose disposal. We investigated the ... [more ▼]
The aim of this study was to investigate whether the osmolality of a glucose solution, ingested at the beginning of a prolonged exercise bout, affects exogenous glucose disposal. We investigated the hormonal and metabolic response to a 50-g glucose load dissolved in either 200 (protocol A), 400 (protocol B), or 600 (protocol C) ml of water and given orally 15 min after adaptation to exercise in five healthy male volunteers. Naturally labeled [13C]glucose was used to follow the conversion of the ingested glucose to expired-air CO2. Total carbohydrate oxidation (indirect calorimetry) was similar in the three protocols (A, 237 +/- 20; B, 258 +/- 17; C, 276 +/- 20 g/4 h), as was lipid oxidation (A, 128 +/- 4; B, 132 +/- 15; C, 124 +/- 12 g/4 h). Exogenous glucose oxidation rates were similar under the three experimental conditions, and the total amount of exogenous glucose utilized was slightly, but not significantly, increased with the more diluted solution (A, 42.6 +/- 4.4; B, 43.4 +/- 4.1; C, 48.7 +/- 7.2 g/4 h). The blood glucose response was similar in the three protocols. Thus, within the range investigated, the osmolality of the glucose solution ingested had no significant influence either on its oxidation (which was 86-98% of the load ingested) or on the utilization of endogenous carbohydrate, lipid, or protein stores. [less ▲]Detailed reference viewed: 21 (0 ULg)
Les cures de jeûne modifié, protidique ou glucido-protidique, dans le traitement de l'obésité morbide.
SCHEEN, André ; ; SCHEEN, Myriam et al
in Médecine et Nutrition (1988), 24Detailed reference viewed: 54 (1 ULg)
Adaptations au sport du diabetique traite par insuline.
Jandrain, Bernard ; Pirnay, Freddy ; Scheen, André et al
in Diabète & Métabolisme (1988), 14(2), 127-35
Performing muscular exercise regularly is generally recommended to diabetics; indeed, exercise increases muscle insulin sensitivity, helps fighting overweight and, at least partly, tends to correct plasma ... [more ▼]
Performing muscular exercise regularly is generally recommended to diabetics; indeed, exercise increases muscle insulin sensitivity, helps fighting overweight and, at least partly, tends to correct plasma lipids abnormalities, thus contributing to limit the development of atherosclerosis. Moreover, the practice of sport is beneficial from a psychological point of view, because, thanks to it, diabetic patients can match, even surpass, "the others" and overcome what they often consider as a disability. However, diabetes--especially type 1, insulin dependent, diabetes--deeply modifies the metabolic adaptations to muscular exercise; consequently, exercise must be performed only in good metabolic control conditions, for avoiding a worsening of ketonaemia. In adequately controlled diabetics, muscular exercise can be beneficial by reducing blood glucose levels; it can also lead to hypoglycaemia occurring during or after the exercise bout. In order to reduce the risk of exercise-induced hypoglycaemia, diabetics have to know how to modify three essential parameters of their treatment: (1) increase carbohydrate intake before, during or after exercise; (2) reduce the dose of the insulin acting during exercise, and this in relation to the usual doses and to exercise intensity; (3) under some circumstances, modify the site of insulin injection according to the type of exercise performed. Taking into account these parameters, some general rules can be assessed, which are to be adapted to every particular situation; the use of home blood glucose monitoring before and after exercise is not only useful but sometimes mandatory.(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]Detailed reference viewed: 131 (10 ULg)
Changes in plasma and erythrocyte magnesium concentrations during protein- sparing modified fast (PSMF) in obese subjects: comparison Alburone versus Nutroclin VLC.
PAQUOT, Nicolas ; ; Scheen, André et al
Poster (1987, April 03)Detailed reference viewed: 22 (0 ULg)
Prevention of metabolic alterations by insulin supplements administered either before or after 2-h nocturnal interruption of CSII.
Scheen, André ; ; Jandrain, Bernard et al
in Diabetes Care (1987), 10(5), 567-72
To evaluate the efficacy of a bolus insulin injection to prevent the metabolic alterations induced by a 2-h nocturnal interruption of a continuous subcutaneous insulin infusion (CSII), nine type I ... [more ▼]
To evaluate the efficacy of a bolus insulin injection to prevent the metabolic alterations induced by a 2-h nocturnal interruption of a continuous subcutaneous insulin infusion (CSII), nine type I (insulin-dependent) C-peptide-negative diabetic patients were studied from 2200 to 0800 h during two randomized tests. An insulin bolus (2.1 +/- 0.2 U) was administered via the pump either at 2300 h, just before CSII interruption, or at 0100 h, after reactivating the pump at its usual basal rate (1.05 +/- 0.11 U/h). The insulin bolus at 2300 h induced a significant rise in plasma free-insulin levels at 2400 h (+6.9 +/- 1.8 mU/L, P less than .01), resulting in an early and marked fall in blood glucose concentrations between 2300 and 0100 h (-2.7 +/- 0.5 mM, P less than .001), with hypoglycemic values in five patients. The insulin bolus at 0100 h counteracted the fall in plasma free-insulin levels observed between 2300 and 0100 h and significantly increased plasma insulin at 0200 h (+3.2 +/- 0.8 mU/L, P less than .01). Blood glucose concentrations that remained stable during the 2-h arrest of the pump fell significantly between 0100 and 0400 h (-2.1 +/- 0.5 mM, P less than .005). This fall rate was significantly lower than that measured within the 3 h after the insulin bolus given before CSII interruption but significantly higher than that observed in a reference control group of patients whose pump was functioning normally throughout the night.(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]Detailed reference viewed: 9 (0 ULg)
U-100 insulin gives some protection against metabolic deterioration due to CSII interruption.
Scheen, André ; ; Jandrain, Bernard et al
in Diabetes Care (1987), 10(6), 707-11
We investigated the influence of insulin concentration within the insulin pump on the metabolic and plasma free-insulin changes induced by a 6-h nocturnal interruption of continuous subcutaneous insulin ... [more ▼]
We investigated the influence of insulin concentration within the insulin pump on the metabolic and plasma free-insulin changes induced by a 6-h nocturnal interruption of continuous subcutaneous insulin infusion (CSII) in five C-peptide-negative insulin-dependent diabetic patients with low circulating levels of anti-insulin antibodies. We compared the changes in blood glucose, plasma free fatty acids, 3-hydroxybutyrate, and free insulin during the interruption from 2300 to 0500 h of the Nordisk Infuser loaded with either U-100 or U-20 regular insulin. The decrease in plasma free-insulin levels was slower, resulting in a significantly delayed and smaller increase in blood glucose levels (2.4 +/- 1.6 vs. 7.6 +/- 2.9 mM, P less than .025) when the pump contained U-100 instead of U-20 insulin. Although the increases in levels of plasma free fatty acids were similar in both tests, the rise in plasma 3-hydroxybutyrate levels tended to be reduced with U-100 insulin (414 +/- 139 vs. 639 +/- 67 microM, P less than .10). Thus, our observations indicate that U-100 insulin gives some protection against the metabolic deterioration due to the interruption of CSII so that diabetic patients may be able to remain without the pump for longer periods with concentrated rather than diluted insulin. [less ▲]Detailed reference viewed: 20 (0 ULg)
Utilisation d'une charge orale de glucose donnée avant, pendant ou après un exercice musculaire prolongé
Lefebvre, Pierre ; ; et al
in Cahiers de Nutrition et de Diététique (1986), XXIDetailed reference viewed: 22 (1 ULg)
Metabolic alterations after a two-hour nocturnal interruption of a continuous subcutaneous insulin infusion.
Scheen, André ; ; Jandrain, Bernard et al
in Diabetes Care (1984), 7(4), 338-42
In order to evaluate the metabolic consequences of a 2-h nocturnal interruption of continuous subcutaneous insulin infusion (CSII), seven insulin-dependent diabetic patients without residual insulin ... [more ▼]
In order to evaluate the metabolic consequences of a 2-h nocturnal interruption of continuous subcutaneous insulin infusion (CSII), seven insulin-dependent diabetic patients without residual insulin secretion were investigated. The changes in blood glucose, plasma free insulin, glucagon, free fatty acids, and 3-hydroxybutyrate (3 OH-B) concentrations have been compared during two randomized tests carried out either during the normal functioning of a Mill-Hill pump from 10 p.m. to 8 a.m. (1.00 +/- 0.06 U insulin/h, keeping adequate metabolic control) or during the same conditions but with a deliberate arrest of the pump between 11 p.m. and 1 a.m. Considering the value recorded at 11 p.m. as reference, interruption of the insulin infusion resulted in: (1) a rapid (already significant after 1 h) and sustained (maximal fall: --12.5 +/- 2.5 mU/L at 3 a.m.) decrease in plasma free insulin; (2) a delayed (significant after 4 h) and linear rise in blood glucose (maximal increase: + 4.0 +/- 1.3 mmol/L at 5 a.m.); (3) an early (significant at midnight) and prolonged rise in plasma free fatty acids (+ 387 +/- 148 mumol/L at 3 a.m.); (4) a delayed (significant after 3 h) and sustained increase in plasma 3 OH-B (+ 347 +/- 88 mumol/L at 3 a.m.); and (5) no significant changes in plasma glucagon. Thus, a 2-h interruption of CSII in resting nocturnal conditions is sufficient to induce significant, delayed, and sustained metabolic alterations in C-peptide-negative patients despite good baseline blood glucose control. Resetting the pump at its basal rate is insufficient to quickly restore adequate circulating insulin levels and effectively counteract the metabolic disturbances. The efficacy of a bolus insulin injection in these conditions should be evaluated. [less ▲]Detailed reference viewed: 8 (0 ULg)