TY - JOUR
T1 - Six and 12 weeks of caloric restriction increases β cell function and lowers fasting and postprandial glucose concentrations in people with type 2 diabetes
AU - Sathananthan, Matheni
AU - Shah, Meera
AU - Edens, Kim L.
AU - Grothe, Karen B.
AU - Piccinini, Francesca
AU - Farrugia, Luca P.
AU - Micheletto, Francesco
AU - Man, Chiara Dalla
AU - Cobelli, Claudio
AU - Rizza, Robert A.
AU - Camilleri, Michael
AU - Vella, Adrian
PY - 2015
Y1 - 2015
N2 - Background: Caloric restriction alone has been shown to improve insulin action and fasting glucose metabolism; however, the mechanism by which this occurs remains uncertain. Objective: We sought to quantify the effect of caloric restriction on β cell function and glucose metabolism in people with type 2 diabetes. Methods: Nine subjects (2 men, 7 women) with type 2 diabetes [BMI (in kg/m2): 40.6 ± 1.4; age: 58 ± 3 y; glycated hemoglobin: 6.9% ± 0.2%] were studied using a triple-tracer mixed meal after withdrawal of oral diabetes therapy. The oral minimal model was used to measure β cell function. Caloric restriction limited subjects to a pureed diet (<900 kcal/d) for the 12 wk of study. The studies were repeated after 6 and 12 wk of caloric restriction. Results: Fasting glucose concentrations decreased significantly from baseline after 6 wk of caloric restriction with no further reduction after a further 6 wk of caloric restriction (9.8 ± 1.3, 5.9 ± 0.2, and 6.2 ± 0.3 mmol/L at baseline and after 6 and 12 wk of caloric restriction, respectively; P = 0.01) because of decreased fasting endogenous glucose production (EGP: 20.4 ± 1.1, 16.2 ± 0.8, and 17.4 ± 1.1 μmol · kg-1 · min-1 at baseline and after 6 and 12 wk of caloric restriction, respectively; P = 0.03). These changes were accompanied by an improvement in β cell function measured by the disposition index (189 ± 51, 436 ± 68, and 449 ± 67 10-14 dL · kg-1 · min-2 · pmol-1 at baseline and after 6 and 12 wk of caloric restriction, respectively; P = 0.01). Conclusions: Six weeks of caloric restriction lowers fasting glucose and EGP with accompanying improvements in β cell function in people with type 2 diabetes. An additional 6 wk of caloric restriction maintained the improvement in glucose metabolism.
AB - Background: Caloric restriction alone has been shown to improve insulin action and fasting glucose metabolism; however, the mechanism by which this occurs remains uncertain. Objective: We sought to quantify the effect of caloric restriction on β cell function and glucose metabolism in people with type 2 diabetes. Methods: Nine subjects (2 men, 7 women) with type 2 diabetes [BMI (in kg/m2): 40.6 ± 1.4; age: 58 ± 3 y; glycated hemoglobin: 6.9% ± 0.2%] were studied using a triple-tracer mixed meal after withdrawal of oral diabetes therapy. The oral minimal model was used to measure β cell function. Caloric restriction limited subjects to a pureed diet (<900 kcal/d) for the 12 wk of study. The studies were repeated after 6 and 12 wk of caloric restriction. Results: Fasting glucose concentrations decreased significantly from baseline after 6 wk of caloric restriction with no further reduction after a further 6 wk of caloric restriction (9.8 ± 1.3, 5.9 ± 0.2, and 6.2 ± 0.3 mmol/L at baseline and after 6 and 12 wk of caloric restriction, respectively; P = 0.01) because of decreased fasting endogenous glucose production (EGP: 20.4 ± 1.1, 16.2 ± 0.8, and 17.4 ± 1.1 μmol · kg-1 · min-1 at baseline and after 6 and 12 wk of caloric restriction, respectively; P = 0.03). These changes were accompanied by an improvement in β cell function measured by the disposition index (189 ± 51, 436 ± 68, and 449 ± 67 10-14 dL · kg-1 · min-2 · pmol-1 at baseline and after 6 and 12 wk of caloric restriction, respectively; P = 0.01). Conclusions: Six weeks of caloric restriction lowers fasting glucose and EGP with accompanying improvements in β cell function in people with type 2 diabetes. An additional 6 wk of caloric restriction maintained the improvement in glucose metabolism.
KW - Bariatric surgery
KW - Caloric restriction
KW - Disposition index
KW - Endogenous glucose production
KW - Gastric emptying
KW - Insulin action
KW - Insulin secretion
UR - http://www.scopus.com/inward/record.url?scp=84941114575&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84941114575&partnerID=8YFLogxK
U2 - 10.3945/jn.115.210617
DO - 10.3945/jn.115.210617
M3 - Article
C2 - 26246321
AN - SCOPUS:84941114575
SN - 0022-3166
VL - 145
SP - 2046
EP - 2051
JO - Journal of Nutrition
JF - Journal of Nutrition
IS - 9
ER -