Effect of carbohydrate on insulin action

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Hi All,

The pdf-available below paper suggests maybe that carbohydrates taken before

fasts

increases post-fast insulin sensitivity.

Svanfeldt M, Thorell A, Hausel J, Soop M, Nygren J, Ljungqvist O.

Effect of " preoperative " oral carbohydrate treatment on insulin action--a

randomised

cross-over unblinded study in healthy subjects.

Clin Nutr. 2005 Oct;24(5):815-21.

PMID: 15979768

.... Six healthy volunteers underwent hyperinsulinaemic (0.8 mU/kg/min),

normoglycaemic (4.5 mmol/l) clamps and indirect calorimetry on four occasions in

a

crossover-randomised order; after overnight fasting (CC), after a single evening

dose (800 ml) of the drink (LC), after a single morning dose (400 ml, CL) and

after

intake of the drink in the evening and in the morning before the clamp (LL). ...

Insulin sensitivity was higher in CL and LL (9.2+/-1.5 and 9.3+/-1.9 mg/kg/min,

respectively) compared to CC and LC (6.1+/-1.6 and 6.6+/-1.9 mg/kg/min, P<0.01

vs.

CL and LL). ...

.... Starvation induces marked insulin resistance in healthy subjects.6 Animal

studies indicate that the metabolic setting at the onset of various types of

stress

may affect outcome. For example, survival after blood loss is increased if rats

are

fed as opposed to starved.7 ...

.... Table 1. Characteristics of the volunteers and randomisation order.

==========================

No. Gender Age (yr) BMI (kg/m2)----Randomisation order

---CC LC CL LL

==========================

1 Male 25 23.3 4 3 2 1

2 Female 40 21.6 4 1 2 3

3 Male 25 22.6 3 4 1 2

4 Female 39 21.0 4 1 2 3

5 Male 27 21.4 3 4 2 1

6 Male 68 21.9 1 3 2 4

==========================

Six healthy volunteers underwent hyperinsulinaemic, normoglucaemic clamps and

indirect calorimetry in the morning on four occasions in a randomised order;

after

traditional fasting (CC), after ingestion of a clear carbohydrate-rich drink

(drink)

in the evening (LC), after ingestion of the drink in the morning (CL) and after

ingestion of the drink both in the previous evening and in the morning before

the

clamp (LL).

.... 800 ml of the drink (12.6% carbohydrates, 50 kcal/100 ml, 240 mOsmol/l,

Nutricia preOp®, Nutricia, Zoetermeer, The Netherlands) ...

.... Table 2. Glucose and insulin.

=================================

Basal 30 min 60 min 90 min 120 min Steady state

=================================

Glucose

CL 4.5±0.4 7.9±1.3** 6.6±1.7* 5.0±1.4 4.4±0.7 4.4±0.0

LL 4.6±0.3 7.5±0.7** 6.6±1.6* 5.5±1.1 4.4±0.6 4.5±0.1

Insulin

CC 12.3±3.5 10.1±3.2 9.6±3.4 9.7±2.8 9.6±1.1 91.4±26.0**

LC 11.7±3.1 9.2±2.1 9.5±1.9* 9.1±2.2 12.4±6.9 93.5±23.3**

CL 12.7±2.4 105.2±36.5** 59.1±23.5** 27.2±10.6* 14.9± 4.7 89.7±20.5**

LL 12.0±3.9 86.8±43.1** 50.3±24.9* 28.2±16.0 14.8±6.2 96.4±19.2**

=================================

Glucose (mmmol/l) and insulin (mU/l) were measured at basal, at time 30, 60, 90

and

120 min and during steady state of a hyperinsulinaemic normoglycaemic clamp in

six

healthy volunteers in the morning on four occasions in a randomised order; after

traditional fasting (CC), after ingestion of carbohydrates (drink) in the

evening

(LC), after ingestion of the drink in the morning (CL) and after ingestion of

the

drink both in the previous evening and in the morning before the clamp (LL).

* and ** indicate P<0.05 and P<0.01 vs. basal.

Values are mean±SD.

.... Table 3. Glucose and fat oxidation.

=================================

Study Basal 30 min 90 min Steady state

=================================

Glucose oxidation CC 1.76±0.93 1.98±0.78 1.91±0.81 3.18±0.81**

LC 1.59±1.02 1.89±0.81 1.48±0.87 3.42±0.82**

CL 1.69±1.16 3.96±1.39** 3.28±0.81** 4.25±0.61**

LL 0.85±0.84 3.57±0.71** 2.82±0.59** 3.75±0.74**

Fat oxidation CC 0.74±0.41 0.68±0.28 0.72±0.35 0.38±0.31*

LC 0.68±0.52 0.66±0.40 0.91±0.35 0.28±0.27*

CL 0.81±0.43 0.01±0.62** 0.13±0.43** & #8722;0.07±0.28**

LL 0.77±0.90 0.05±0.26 0.28±0.22 0.18±0.26

=================================

Glucose and fat oxidation (mg/kg/min) measured with indirect calorimetry at

basal,

at time 30 min, 90 min and during steady state of a hyperinsulinaemic

normoglycaemic

clamp in six healthy volunteers in the morning on four occasions in a randomised

order; after traditional fasting (CC), after ingestion of carbohydrates (drink)

in

the evening (LC), after ingestion of the drink in the morning (CL) and after

ingestion of the drink both in the previous evening and in the morning before

the

clamp (LL).

* and ** indicate P<0.05 and P<0.01 vs. basal.

Values are mean±SD.

Al Pater, PhD; email: old542000@...

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