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Type: Journal article
Title: The duodenal glucose load impacts the oral disposition index in healthy subjects
Author: Marathe, C.
Feinle-Bisset, C.
Pilichiewicz, A.
Lange, K.
Jones, K.
Rayner, C.
Kahn, S.
Horowitz, M.
Citation: Diabetic Medicine, 2015; 32(11):1500-1503
Publisher: Wiley-Blackwell
Issue Date: 2015
ISSN: 0742-3071
Statement of
C. S. Marathe, C. Feinle-Bisset, A. Pilichiewicz, K. Lange, K. L. Jones, C. K. Rayner, S. E. Kahn and M. Horowitz
Abstract: Aim: In healthy subjects, the oral disposition index (ratio of insulin response to insulin sensitivity) is predictive of the development of Type 2 diabetes. Gastric emptying, which exhibits a substantial interindividual variation, is a major determinant of postprandial glycaemia in health and diabetes. We sought to determine whether the rate of intraduodenal glucose delivery affects the disposition index in people without diabetes. Methods: Nineteen Caucasian males received glucose infusions via an intraduodenal catheter at either 2 kcal/min (ID2) or 4 kcal/min (ID4) for 120 min, on two separate days with measurements of blood glucose (G) and plasma insulin (I) at frequent intervals. The insulin response was estimated by the ratio of the change in insulin to that of change in glucose at 30 min (∆I0–30/∆G0–30) and 60 min (∆I0–60/∆G0–60). Insulin sensitivity was estimated as 1/fasting insulin. The oral disposition index (DI) was calculated as ∆I0–30/∆G0–30 × 1/fasting insulin and ∆I0–60/∆G0–60 × 1/fasting insulin. Results: The overall glycaemic response was comparable on both days, but the insulin response was much greater at ID4 when calculated at either 30 or 60 min (P < 0.05). DI was also greater (P < 0.05) in response to ID4 than ID2. Conclusions: The rate of duodenal glucose delivery has a major impact on insulin release and, thereby, DI. This suggests that the rate of gastric emptying, which determines duodenal glucose delivery, is a determinant of DI.
Keywords: Intestinal Mucosa
Insulin Resistance
Dietary Carbohydrates
Blood Glucose
Intubation, Gastrointestinal
Gastric Emptying
Intestinal Absorption
Insulin-Secreting Cells
Glycemic Load
Insulin Secretion
Rights: © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK
DOI: 10.1111/dme.12802
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