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Biomedical subjects

O Rasmussen

Publications and source records attributed to O Rasmussen.

At least 19 recordsLinked to original sources

Differential effects of saturated and monounsaturated fat on blood glucose and insulin responses in subjects with non-insulin-dependent diabetes mellitus.

To compare the metabolic effect of coingestion of saturated and monounsaturated fats with potato, 12 subjects with non-insulin-dependent diabetes mellitus (NIDDM) received 300 g mashed potato alone or in combination with 40 g olive oil, 80 g olive oil, 50 g butter, or 100 g butter, respectively. The blood glucose response area to potatoes with 100 g butter (448 +/- 68 mmol.240 min/L) was significantly lower than after the four other meals: 596 +/- 63 (potato alone), 649 +/- 82 (potato + 40 g olive oil), 587 +/- 80 (potato + 50 g butter), and 604 +/- 81 (potato + 80 g olive oil) nmol.240 min/L, P < 0.05, respectively. The insulin response was significantly increased by adding 50 and 100 g butter, whereas addition of 40 and 80 g olive oil had no effect. The fatty acid concentration was higher when 100 g butter was added to the potato meal than when it was not (0.67 +/- 0.05 compared with 0.48 +/- 0.07 mmol/L, P < 0.05). Fatty acid concentrations were similar to those found for the other meals. The triacylglycerol response increased in a dose-dependent manner with the fat content of the meals irrespective of the type of fat. We conclude that butter increases the insulin response more than does olive oil, and large amounts of butter also increase fatty acid and triacylglycerol concentrations.

Adult

Bilateral gluteus maximus transposition for anal incontinence.

Seven patients (five women and two men) with anal incontinence in whom previous surgery had failed, were treated by bilateral gluteus maximus transposition. All patients were incontinent to solid stool. Previous surgery was postanal repair in four women and secondary overlapping suture for obstetric tear in one. The two men were treated in childhood for anal atresia. No covering stoma was used. Wound infection occurred in three patients, requiring surgical drainage in two. After follow-up of more than 1 year three patients experienced improved continence but in four continence was unchanged. Anorectal physiology studies showed moderately increased resting and squeeze pressures in patients who were improved by the operation, but none could retain more than 200 ml of viscous fluid instilled into the rectum. No change in rectal sensitivity or volume tolerance was found. This preliminary series does not indicate that better results are obtained by gluteus maximus transposition than by unstimulated graciloplasty.

Adult

Effects of glipizide on glucose metabolism and muscle content of the insulin-regulatable glucose transporter (GLUT 4) and glycogen synthase activity during hyperglycaemia in type 2 diabetic patients.

To examine whether sulphonylureas influence hyperglycaemia-induced glucose disposal and suppression of hepatic glucose production (HGP) in type 2 diabetes mellitus, a 150-min hyperglycaemic (plasma glucose 14 mmol/l) clamp with concomitant somatostatin infusion was used in eight type 2 diabetic patients before and after 6 weeks of glipizide (GZ) therapy. During the clamp a small replacement dose of insulin was given (0.15 mU/kg per min). Isotopically determined glucose-induced glucose uptake was similar before and after GZ administration which led to improved glycaemic control (basal plasma glucose 12.2 +/- 1.3 vs 8.9 +/- 0.7 mmol/l; P < 0.01). Glucose-induced suppression of HGP was, however, more pronounced during GZ treatment (0.96 +/- 0.14 vs 1.44 +/- 0.20 mg/kg per min; P < 0.02). Following GZ treatment hyperglycaemia failed to stimulate glycogen synthase activity. Moreover, GZ resulted in a significant increase in the immunoreactive abundance of the insulin-regulatable glucose transport protein (GLUT 4) (P < 0.02). In conclusion, these results suggest that GZ therapy in type 2 diabetic patients enhances hepatic sensitivity to hyperglycaemia, while glucose-induced glucose uptake remains unaffected. In addition, GZ tends to normalize the activity of glycogen synthase and increases the content of GLUT 4 protein in skeletal muscle.

Adult

Decrease in von Willebrand factor levels after a high-monounsaturated-fat diet in non-insulin-dependent diabetic subjects.

High levels of von Willebrand factor (vWF) have been reported in diabetics with vascular complications, suggesting a role for this protein in the development of cardiovascular complications in non-insulin-dependent diabetes mellitus (NIDDM). Recently, a diet rich in monounsaturated fatty acids (MUFA) has been found to improve glycemic control and decrease diurnal blood pressure as compared with a high-carbohydrate (H-CHO) diet in NIDDM subjects. To study the impact of MUFA on the hemostatic system, we compared the levels of vWF, fibrinogen, fibronectin, and alpha 2-macroglobulin before and after 3 weeks on a high-MUFA (H-MUFA) diet and on an isocaloric H-CHO diet in 15 NIDDM subjects. In a crossover study, the patients were randomly assigned to a H-CHO diet (50% carbohydrate, 30% fat [10% MUFA]) or a H-MUFA diet (30% carbohydrate, 50% fat [30% MUFA]). Before and on the last day of the two diets, vWF, fibrinogen, fibronectin, and alpha 2-macroglobulin levels were measured. The H-MUFA diet caused a decrease in vWF from 1.31 +/- 0.08 to 1.13 +/- 0.08 U/mL (P < .004), whereas an unchanged level was observed after a H-CHO diet (1.19 +/- 0.11 v 1.25 +/- 0.11 U/mL, NS). The relative changes in vWF during 3 weeks on a H-MUFA and on a H-CHO diet attained -12.5% +/- 3.2% versus 5.7% +/- 3.5%, respectively (P < .0001). Furthermore, unchanged levels of fibrinogen, fibronectin, and alpha 2-macroglobulin were seen after usage of the two diets.(ABSTRACT TRUNCATED AT 250 WORDS)

Cross-Over Studies

Effect of alcohol on glucose, insulin, free fatty acid and triacylglycerol responses to a light meal in non-insulin-dependent diabetic subjects.

Alcohol accounts for 4-6% of the average energy intake in most Western countries. Alcohol-induced hypoglycaemia is a well-known and feared complication in insulin-dependent diabetic subjects, but little attention has been paid to the impact of alcohol on carbohydrate metabolism in non-insulin-dependent diabetes. The aim of the present study was to investigate in non-insulin-dependent diabetic subjects the acute metabolic effects of a moderate amount of alcohol taken with a light meal, conditions chosen to mimic an everyday situation. The patients received 500 ml non-alcoholic beer with an alcohol content (ml/l) of 0 (treatment A) and 54 (treatment B) together with a light meal, implying identity of the contents of ingredients except for alcohol. We found similar serum glucose, insulin, free fatty acid and triacylglycerol responses irrespective of addition of a modern amount of alcohol. In conclusion, a moderate amount of alcohol can be taken with a meal without eliciting hypoglycaemia in non-insulin-dependent diabetic subjects.

Blood Glucose

Dose-dependency of the glycemic response to starch-rich meals in non-insulin-dependent diabetic subjects: studies with varying amounts of white rice.

The study objective was to determine the dose-response relationships between postprandial blood glucose, insulin, and glucagon responses and the amount of starch ingested in non-insulin-dependent diabetic (NIDDM) subjects. Three test meals were served in random order with a 7-day interval. Mixed meals of 23, 46, and 69 g (raw weight) parboiled white rice containing approximately 20, 40, and 60 g available carbohydrate were served cooked with 167 g meat sauce on 3 separate days. Patients ingested the meals after a 12-hour fast. Clear-cut dose-response relationships between the amount of starch ingested and postprandial peak blood glucose values (R = .99), glucose response areas (R = .99), and insulin response areas (R = .98) were found. Glucose response areas to meals of 20, 40, and 60 g carbohydrate as white rice differed significantly (P < .05) at 139 +/- 58, 285 +/- 86, and 453 +/- 113 mmol/L x 280 min, respectively. Insulin response areas to meals of 23 g rice (11.382 +/- 2,220 pmol/L x 240 min) were significantly lower compared with response areas to 46 g rice (18.138 +/- 3,522 pmol/L x 240 min) and 69 g rice (21.312 +/- 2,970 pmol/L x 240 min), with the latter two values being similar. Glucagon response areas showed an inverse pattern to glucose response areas, reaching 3,450 +/- 823, 2,715 +/- 651, and 2,168 +/- 553 pmol/L x 240 min, but differences did not reach statistical significance.

Aged

Dose-dependency of the glycemic response to starch-rich meals in insulin-dependent diabetic subjects: studies at constant insulinemia.

The study objective was to determine the dose-response relationship of postprandial blood glucose response areas to the amount of starch ingested in insulin-dependent diabetic (IDDM) subjects. Three test meals were served in random order with a 7-day interval to seven IDDM subjects attending the outpatient clinic at Aarhus Kommunehospital. Mixed meals of 23, 46, and 69 g parboiled white rice (raw weight) containing approximately 20, 40, and 60 g available carbohydrate were served cooked on three separate days. The patients had achieved normoglycemic blood glucose levels 2 hours before meal intake by means of an artificial pancreas (Biostator, Miles Laboratories, Elkhart, IN), which also provided constant insulin infusion during the study periods (0 to 180 minutes). A clear-cut dose-response relationship between the amount of starch ingested and postprandial peak blood glucose values (r = .96) as well as glucose response areas (r = .99) was found. Glucose response areas to meals containing 20, 40, and 60 g carbohydrate differed significantly (P < .01), attaining 291 +/- 77, 643 +/- 75, and 878 +/- 99 mmol/L x 180 minutes, respectively. Glucosuria accounted for 0.6 and 1.6 g (NS) after 20 and 40 g carbohydrate, whereas 5.0 g glucose (P < .05) was detected following 60 g carbohydrate. Similar mean serum free insulin levels (range, 102 to 150 pmol/L) during the three study periods were found.

Adolescent

Day-to-day variation of the glycemic response in subjects with insulin-dependent diabetes with standardized premeal blood glucose and prandial insulin concentrations.

To study the day-to-day variation in the glycemic response to a starch-rich meal in subjects with insulin-dependent diabetes mellitus (IDDM), eight young subjects with IDDM were served test meals of 100 g white bread on 3 separate days. They had achieved normoglycemia 2 h before the test meals by means of a glucose clamp and a constant insulin infusion was provided during the study period. Mean areas under the response curves of blood glucose to the three meals (above basal) were not different: 1067 +/- 93, 1028 +/- 91, and 970 +/- 42 mmol/L x 180 min (NS) and no difference in insulin concentrations was found. The mean (+/- 95% confidence interval) of blood glucose area under the response curves for one test meal was 1067 +/- 230 mmol/L x 180 min and for the test meal repeated three times was 1021 +/- 133 mmol/L x 180 min. Intra- and interperson components of variance were 26% and 74%, respectively, of the total variance of blood glucose areas.

Adult

Wine for type 2 diabetic patients?

To ensure an acceptable quality of life for Type 2 diabetic patients, the food recommendations have to be as liberal and individualized as possible. Unfortunately, disagreements exists about the consumption of different types of wine. Diabetic patients are advised by some to restrain their wine intake and to use dry wine containing little carbohydrate, while others are more liberal. The purpose of this study was to evaluate the effects of dry and sweet wine on the glycaemic control in Type 2 diabetes. Twelve diabetic patients consumed a light meal with either 300 ml tap water 300 ml dry white wine, 300 ml sweet white wine with ethanol added or 300 ml dry white wine with glucose added. Similar glucose, insulin, and triglyceride responses were obtained in all four situations. There was a greater suppression of the free fatty acid levels in the three situations with wine as compared with water (p < 0.001). This effect may be caused by an attenuation of the free fatty acid mobilization and esterification of free fatty acids to triglycerides induced by alcohol. Our results indicate that patients with well-controlled Type 2 diabetes can drink moderate amounts of wine with meals without risking acute deterioration of glycaemic control. Whether the wine is dry or sweet has no impact on the glycaemic control.

Adult

Effect of meal frequency on blood glucose, insulin, and free fatty acids in NIDDM subjects.

OBJECTIVE: We studied the effects of meal frequency on blood glucose, serum insulin, and FFAs in 12 NIDDM subjects. RESEARCH DESIGN AND METHODS: Subjects were assigned in random order to two 8-hr observation periods after an overnight fast. They received isocaloric diets with similar composition either as six small or as two large meals. At the end of each study period, an IVGTT was given. RESULTS: Two large meals induced an 84% greater maximum amplitude of glucose excursions than six small meals (6.1 +/- 0.5 vs. 3.3 +/- 0.5 mM, P < 0.005) and higher insulin responses (P < 0.03). The Kg response to an IVGTT did not differ in the two situations. The average FFA level was lowest in response to frequent meals (P < 0.02). CONCLUSIONS: A higher meal frequency acutely subdues glucose excursions and reduces insulin and FFA levels during the daytime in older NIDDM subjects.

Blood Glucose

Acute effects of graded alcohol intake on glucose, insulin and free fatty acid levels in non-insulin-dependent diabetic subjects.

Alcohol-induced hypoglycaemia is a well-known phenomenon in insulin-treated diabetic subjects. Less attention has been paid to the impact of alcohol on blood glucose and insulin responses in non-insulin dependent diabetic subjects. The aim of this study was to investigate the acute metabolic effects of different alcohol contents added to a non-alcohol beer in 10 non-insulin-dependent diabetes mellitus (NIDDM) subjects. The patients received 500 ml non-alcohol beer with an alcohol percentage (v/v) of 0 (A), 2.7 (B), and 5.4 (C), implying identical contents of ingredients except for alcohol. Blood glucose (mean +/- SE) responses were similar in the three situations (395 +/- 59, 365 +/- 86 and 261 +/- 26 mmol/l x 240 min). In contrast, the incremental insulin response areas increased dose dependently to alcohol (5430 +/- 1158, 9336 +/- 2172 and 12336 +/- 2922 pmol/l x 240 min) and showed a linear correlation (r = 0.39; P < 0.03). The average suppression of serum free fatty acid was similar in the three situations (72.4 +/- 4.4%, 76.3 +/- 6.0% and 68.2 +/- 6.3%). In conclusion, intake of small amounts of alcohol does not acutely deteriorate the glycaemic control in NIDDM. The fact that alcohol results in a dose-related elevation in insulin levels with unaltered blood glucose and free fatty acid responses in NIDDM points to an aggravation of insulin resistance.

Aged

Influence of the amount of starch on the glycaemic index to rice in non-insulin-dependent diabetic subjects.

To test whether the glycaemic index is altered by the amount of carbohydrate, meals containing 25 and 50 g carbohydrate as white rice and white bread were taken by seven non-insulin-dependent diabetic subjects. The glycaemic indices to parboiled white rice corresponding to 25 and 50 g carbohydrate were similar, being 55 (SE 10) and 60 (SE 8) respectively. The incremental areas of blood glucose (above basal) to parboiled white rice were significantly lower than to white bread after both an amount corresponding to 25 g carbohydrate (85 (SE 24) mM x 180 min v. 181 (SE 55) mM x 180 min; P less than 0.01) and to 50 g carbohydrate 226 (SE 29) mM x 180 min v. 423 (SE 76) mM x 180 min; P less than 0.01). Similar insulin response areas to 25 g carbohydrate given as parboiled white rice and white bread were found, whereas 50 g carbohydrate as white bread caused a significantly higher insulin response area than parboiled white rice (P less than 0.05). In conclusion, the glycaemic index of parboiled white rice is not affected by the amount of carbohydrate ingested, at least under the present study conditions.

Blood Glucose

Influence of ripeness of banana on the blood glucose and insulin response in type 2 diabetic subjects.

Banana is a popular and tasty fruit which often is restricted in the diet prescribed for diabetic patients owing to the high content of free sugars. However, in under-ripe bananas starch constitutes 80-90% of the carbohydrate content, which as the banana ripens changes into free sugars. To study the effect of ripening on the postprandial blood glucose and insulin responses to banana, 10 type 2 (non-insulin-dependent) diabetic subjects consumed three meals, consisting of 120 g under-ripe banana, 120 g over-ripe banana or 40 g white bread on separate days. The mean postprandial blood glucose response area to white bread (181 +/- 45 mmol l-1 x 240 min) was significantly higher compared with under-ripe banana (62 +/- 17 mmol l-1 x 240 min: p < 0.01) and over-ripe banana (106 +/- 17 mmol l-1 x 240 min: p < 0.01). Glycaemic indices of the under-ripe and over-ripe bananas differed (43 +/- 10 and 74 +/- 9: p < 0.01). The mean insulin response areas to the three meals were similar: 6618 +/- 1398 pmol l-1 x 240 min (white bread), 7464 +/- 1800 pmol l-1 x 240 min (under-ripe banana) and 8292 +/- 2406 pmol l-1 x 240 min (over-ripe banana). The low glycaemic response of under-ripe compared with over-ripe bananas may be ascribed to the high starch content, which has previously been found to be only hydrolysed slowly by alfa-amylase in humans.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose

Assessment of glucose turnover rates in euglycaemic clamp studies using primed-constant [3-3H]-glucose infusion and labelled or unlabelled glucose infusates.

Underestimation of glucose turnover rates has been a problem in clamp studies using primed-constant [3-3H]-glucose infusion technique. Due to slow mixing in interstitial compartments concealed specific activity gradients may arise between plasma and interstitial compartments during intravenous unlabelled glucose infusion. Such specific activity gradients, however, can be prevented if plasma specific activity is maintained constant. Two euglycaemic clamp studies (insulin infusion 40 mU m-2 min-1) were performed in six lean normal subjects. Using conventional unlabelled glucose infusates plasma specific activity declined by 74%, tracer determined glucose appearance was smaller than actual glucose infusion rates (317 +/- 11 vs 366 +/- 15 mg m-2 min-1, p < 0.001), and erroneous negative values were calculated for glucose production (- 49 +/- 7 mg m-2 min-1). Average underestimation during the first 2 h correlated with glucose infusion rates (r = 0.88, p < 0.02). In contrast, when plasma specific activity was maintained constant, using appropriately labelled glucose infusates, tracer determined glucose appearance and glucose infusion rates were similar (385 +/- 16 vs 385 +/- 17 mg m-2 min-1), and negative errors for glucose production were avoided. In conclusion, using unlabelled glucose infusates, as in previous studies, suppression of glucose production is overestimated and stimulation of glucose utilization is underestimated. As errors were greater with larger glucose infusions, the mistakes may have been greatest in insulin sensitive control subjects, and smaller in insulin resistant subjects. Therefore, re-evaluation of hepatic insulin sensitivity seems appropriate in diabetes, obesity, and other insulin resistant states.

Adult

Glycaemic and insulinaemic responses to orange and apple compared with white bread in non-insulin-dependent diabetic subjects.

To study the postprandial blood glucose and insulin responses to exchangeable amounts of simple and complex carbohydrates, eight non-insulin-dependent diabetic subjects consumed 227 g apple, 280 g orange or 50 g white bread on three separate days. The mean postprandial blood glucose response area to white bread (404 +/- 95 mM x 240 min) was significantly higher compared with orange (131 +/- 34 mM x 240 min; P less than 0.05) and apple (157 +/- 57 mM x 240 min; P less than 0.05). Thr glycaemic indices of the fruits were identical: 44 +/- 13 (orange) and 40 +/- 11 (apple). The low glycaemic response to orange and apple may be ascribed to the high content of fructose which is rapidly cleared and metabolized by the liver, without elevating the blood glucose.

Blood Glucose

Direct regeneration of transformed shoots in Brassica napus from hypocotyl infections with Agrobacterium rhizogenes.

Genetically transformed root clones of rapeseed (Brassica napus) were obtained after in vitro infection of excised hypocotyl segments with a wild type strain of Agrobacterium rhizogenes and two strains of A. rhizogenes harbouring kanamycin resistance. The ability of hairy root formation was affected by light and was highly dependent on the location of the infection site at the hypocotyl. Inoculation of decapitated hypocotyls with an intact root system gave rise to direct shoot formation from the site of inoculation. Histological sections showed that several meristems were initiated at the inoculation site. Root and shoot clones were isolated and subcultured axenically in hormone-free liquid MS medium. Identification of transformed root and shoot clones was based on opine assays. Further selection was carried out in kanamycin-enriched medium. All opine-positive root clones showed NPT II (neomycin phosphotransferase) activity. Nearly half of the shoot clones expressed a strong NPT II activity while the rest gave a weak or no NPT II response.

Brassica

Decreased hepatic glucagon responses in type 1 (insulin-dependent) diabetes mellitus.

The effect of glucagon infusion on hepatic glucose production during euglycaemia was evaluated in seven Type 1 (insulin-dependent) diabetic patients and in ten control subjects. In the diabetic subjects normoglycaemia was maintained during the night preceding the study by a variable intravenous insulin and glucose infusion. During the study endogenous insulin secretion was suppressed by somatostatin (450 micrograms/h) and replaced by insulin infusion (0.15 mU.kg-1.min-1). 3H-glucose was infused for isotopic determination of glucose turnover. Plasma glucose was clamped at 5 mmol/l for 2 h 30 min and glucagon (1.5 ng.kg-1.min-1) was then infused for the following 3 h. Hepatic glucose production and glucose utilisation were measured during the first, second and third hour of the glucagon infusion. Basal hepatic glucose production (just prior to glucagon infusion) was similar in diabetic (1.2 +/- 0.3 mg.kg-1.min-1) and control (1.6 +/- 0.1 mg.kg-1.min-1) subjects. In diabetic patients hepatic glucose production rose slowly to 2.1 +/- 0.5 mg.kg-1.min-1 during the first hours of glucagon infusion and stabilized at this level (2.4 +/- 0.5 mg.kg-1.min-1) in the third hour. In control subjects hepatic glucose production increased sharply to higher levels than in the diabetic subjects (3.4 +/- 0.3 mg.kg-1.min-1) during the first and second hour of glucagon infusion (p less than 0.05) and then gradually fell (2.9 +/- 0.4 mg.kg-1.min-1) during the third hour. In conclusion, when stimulated with glucagon at a physiologic plasma concentration diabetic patients had 1) an overall reduced hepatic glucose production response and 2) an abnormal sluggish response pattern.(ABSTRACT TRUNCATED AT 250 WORDS)

3-Hydroxybutyric Acid

Preprandial blood glucose values and glycemic responses in insulin-dependent diabetes mellitus at constant insulinemia.

The influence of preprandial blood glucose (PPBG) concentration on glycemic responses was studied in seven subjects with insulin-dependent diabetes who, by means of the artificial pancreas, had achieved PPBG concentrations of 6, 9, and 17 mmol/L. A test meal of 50 g parboiled rice was given at the three different occasions and a constant insulin infusion was provided during the observation periods. The mean postprandial-blood-glucose-response area (above basal) differed significantly at the three blood glucose concentrations of 6, 9, and 17 mmol/L, reaching 1371, 621, and 179 mmol/L x 240 min, respectively (P less than 0.01). A negative correlation between the PPBG concentrations and the glycemic responses to the test meal was found (r = 0.94; P less than 0.001). The fasting insulin concentration at a PPBG concentration of 17 mmol/L was lower than at a PPBG concentration of 6 and 9 mmol/L. In conclusion, the glycemic responses to a carbohydrate meal are inversely correlated to the PPBG concentration in insulin-dependent diabetic subjects.

Adult