Istituto di Ingegneria Biomedica     
Muscelli E., Mari A., Casolaro A., Camastra S., Seghieri G., Gastaldelli A., Holst J. J., Ferranini E. Separate impact of obesity and glucose tolerance on the incretin effect in normal subjects and type 2 diabetic patients. In: Diabetes, vol. 57 (5) pp. 1340 - 8. American Diabetes Association, 2008.
OBJECTIVE: To quantitate the separate impact of obesity and hyperglycemia on the incretin effect (i.e., the gain in beta-cell function after oral glucose versus intravenous glucose). RESEARCH DESIGN AND METHODS: Isoglycemic oral (75 g) and intravenous glucose administration was performed in 51 subjects (24 with normal glucose tolerance [NGT], 17 with impaired glucose tolerance [IGT], and 10 with type 2 diabetes) with a wide range of BMI (20-61 kg/m(2)). C-peptide deconvolution was used to reconstruct insulin secretion rates, and beta-cell glucose sensitivity (slope of the insulin secretion/glucose concentration dose-response curve) was determined by mathematical modeling. The incretin effect was defined as the oral-to-intravenous ratio of responses. In 8 subjects with NGT and 10 with diabetes, oral glucose appearance was measured by the double-tracer technique. RESULTS: The incretin effect on total insulin secretion and beta-cell glucose sensitivity and the GLP-1 response to oral glucose were significantly reduced in diabetes compared with NGT or IGT (P
URL: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18162504
DOI: 10.2337/db07-1315
Subject UC, area under the time concentration curve
FFM, fat-free mass
GIP, glucose-dependent insulinotropic polypeptide
GLP, glugacon-line peptide
IGT, impaired glucose tolerance
NGT, normal glucose tolerance
OGGT, oral glucose tolerance tests
TTR, tracer-to-tracee ratio

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