1 Sweet-taste receptors, glucose absorption and insulin release: Are LCS nutritionally active? Samuel V. Molinary, Ph.D. Consultant, Scientific & Regulatory Affairs ILSI/NA April 6, 2011 Washington, DC
2 Why is this question being asked now after a century of human exposure to low calorie sweeteners? Recent basic research on the molecular biology of taste receptors and related GI receptors has led to speculation that LCS may interact with the GI glucose sensing system to alter glucose uptake and, consequently, to undermine glucose homeostasis, increase appetite and lead to an increase in obesity.
3 Outline 1. Review the GI sweet receptor and its function in glucose absorption. 2. Briefly review the interaction of LCS with the GI sweet receptor. 3. Examine the speculation re LCS and adverse effects. 4. Review available clinical data that address the speculation. 5. Review recent clinical studies designed to test the hypothesis that LCS are nutritionally active.
4 GI Taste Receptors and Glucose Sensing and Transport
5 Useful Definitions Enterocyte GI cells that actually absorb nutrients from the gut lumen. Enteroendocrine cell GI cells (~1% of total) that sense the presence of nutrients in the gut lumen, release incretin hormones that prepare the enterocytes and body for a nutrient load. GLP-1 glucagon-like peptide, an incretin secreted from L cells. GIP glucose-dependent insulinotropic polypeptide, an incretin secreted from K cells.
6 Glucose absorption across the intestinal wall Glucose is a highly polar molecule that cannot simply diffuse across the gut wall Cells have transporters in their cell membranes for the uptake of glucose In the intestine these transporters occur on both the luminal (apical) and basolateral (blood) sides of the enterocytes
7 Enterocyte G Gut lumen SGLT1 G Cytosol G G ATP ADP GLUT2 GLUT2 G G Blood stream
8 Glucose absorption across the intestinal wall The glucose transporters in enterocyte cell membranes adapt to the amount of glucose available in the gut lumen How is the presence of glucose detected and signalled to the enterocytes? Enteroendocrine cells interspersed with the enterocytes have sweet-taste receptors activation of which produces 2 incretin hormones (GLP-1 and GIP)
9 Enteroendocrine cell Gut lumen Sweet-taste receptor Ca 2+ channel Adenylate cyclase α-g ATP c-amp Kinase activities Synthesis and release of GLP-1 and GIP
10 Glucose absorption across the intestinal wall GLP-1 and GIP are released when the tastereceptor is stimulated and produce 2 effects in the enterocytes: 1. The expression of SGLT-1 on the luminal membrane is increased most effective at low concentrations of glucose 2. GLUT2 is increased and now is also present in the luminal membrane to deal with high glucose concentrations
11 G G Gut lumen GLUT2 SGLT1 G Cytosol G ATP ADP G G GLUT2 GLUT2 G G Blood stream
12 Glucose absorption across the intestinal wall Intense sweeteners can stimulate the intestinal sweet-taste receptors in in vitro studies and cause the same changes in the intestinal epithelium as glucose. Release of GLP-1 and GIP Increase intestinal glucose transporters So why is this an issue? If LCS can have the same effect as glucose on the GI sensing system by increasing incretin secretion, there might be long term physiological consequences re glucose homeostasis and energy balance.
13 Intestinal sweet-taste receptors and insulin release The issue has received attention because GLP-1 and GIP have additional non-local functions, which prepare the body for a glucose load Stimulate gustatory nerves Delay gastric emptying Stimulate the release of insulin What might happen if intestinal sweet tastereceptors are stimulated by an intense sweetener?
14 The hypothesis of Egan and Margolskee (2008) i. stimulation of the sweet-taste receptors in the intestine by low-calorie sweeteners causes increased expression of glucose uptake transporters (SGLT1 and GLUT2) on the enterocytes to enhance glucose uptake, ii. the released GLP-1 and GIP enter the general circulation and increase insulin secretion which lowers blood sugar, iii. this affects glucose homeostasis and the risk of diabetes, iv. the lowered blood sugar increases appetite, leading to increased weight gain.
15 Egan and Margolskee (2008) went on to state Obesity and hyperlipidemias are linked to sugary soft drinks but low calorie diet drinks may further increase the incidence of obesity and/or metabolic syndrome Small studies have associated diet soft drinks with high blood pressure in women and increased weight gain in boys In the absence of calories the balance between taste receptor activation, nutrient assimilation and appetite may be disequilibrated leading to an increase in appetite and overeating when calories are available
16 Experimental basis The experiments on which this hypothesis is based are: 1. In vitro studies exposing mouse & human cell culture lines to various sweeteners. 2. Knockout mouse studies of short duration. 3. Short-term feeding studies in mice. 4. In situ studies in rats. 5. Really beautiful molecular biology studies aimed at defining the enteroendocrine cell to cell signaling mechanism.
17 BUT In vivo studies in humans have shown that ingestion of an intense sweetener does NOT i. Increase appetite ii. Increase food intake iii. Cause an increase in body weight iv. Cause the release of insulin v. Affect glucose homeostasis or control of diabetes Renwick 1994 review
18 The hypothesis as stated by Egan and Margolskee suggests that LCS are nutritionally active with respect to GLP-1 and GIP secretion by the enteroendocrine cells. Several other investigators have also raised this possibility
19 Reasons to question relevance of this hypothesis All modern LCS have large safety databases, which include animal studies of two-years duration at massive daily intakes. If glucose homeostasis is undermined as predicted by Egan/Margolskee, rats ingesting >3000 mg/kg/day for two years should have shown multiple adverse effects. Blood chemistries, histology and in-life data show no evidence of aberrations in glucose control; there is no evidence of obesity.
20 Long-term studies from the sucralose and rebaudioside A safety data bases
21 Sucralose Clinical Studies (1) Normal Volunteers: N=48, duration = 12 weeks + 4 week screening phase and a 4 week follow-up phase. The study was a double-blind, placebo-controlled, randomized, parallel group designed to assess the effect of sucralose on glucose homeostasis in healthy male volunteers. Study parameters: HbA1c, insulin, C-peptide, glucagon and glucose. OGTT s given during study. Capsules taken 3X per day with meals (1000 mg total). Achieved daily dose = mg/kg/day vs. ADI of 15 mg/kg/day. (High daily intake is ~ 2.4 mg/kg/day) Result: No effect on glucose homeostasis, all values were within normal limits and all OGTT s were normal.
22 Sucralose Clinical Studies (1) The Egan/Margolskee hypothesis suggests that sucralose ingestion should have increased glucose transport by increasing incretin secretion by the enteroendocrine cells, thus modifying blood glucose and insulin levels. The C-peptide level, and possibly the blood glucose levels, should have increased even in these normal subjects over the three-month study duration. BUT no effects were observe in any parameter.
23 Sucralose Clinical Studies (2) Type II diabetic subjects: N =128, duration = three months + 8 week screening phase and a 4 week followup phase. The study was a double-blind, placebo-controlled, randomized, parallel group, multi-center trial designed to assess the effect of sucralose on glucose homeostasis in type II diabetics. Of the 128 subjects, 64 were being treated with oral hypoglycemic agents and 64 with insulin. Study parameters: HbA1c, insulin, C-peptide, glucagon and glucose. OGTT s given during study. Capsules taken 2X daily with meals. Achieved daily dose = 7.5 mg/kg/day.
24 Sucralose Clinical Studies (2) There was no difference between the cellulose placebo controls and the sucralose group. There was no change in medication during the study. Compliance was monitored by measuring sucralose in the urine of the subjects. There were no differences in any safety measure. There was no evidence suggesting that glucose control was undermined in this study of diabetic subjects.
25 Stevia Clinical Studies (1) Normotensive adults: N = 100, duration = 4 weeks + 4 week screening period. Study was a randomized, double-blind trial designed to evaluate the hemodymanic effects of 1000 mg/day (capsules 500mg 2X daily with meals) of rebaudioside A vs. placebo. Compared resting BP, mean BP, HR and 24 hour ambulatory BP responses. Result: no clinically important changes in BP in healthy, normotensive adults.
26 Stevia Clinical Studies (2) Type II diabetic subjects: N = 122, duration = 16 weeks + 2 week screening phase. The study was a double-blind, placebo controlled multicenter trial designed to assess the effect of rebaudioside A on glucose homeostasis and blood pressure. Study parameters: HbA1c, insulin, C-peptide, and glucose. Measurements of BP, BW and fasting lipids were also made. Capsules taken 2X daily with meals, total of 1000 mg steviol glycoside. Results: there were no differences between the rebaudioside A group and the placebo group in any parameter.
27 Recently published clinical studies
28 Recent Clinical Studies 1. Ma et al (2009): measured circulating levels of GLP-1, GIP, insulin, blood glucose and gastric emptying after intragastric infusions of sucrose, sucralose or saline control in 500 ml of iso-osmotic solutions in 7 healthy subjects. Result:: only sucrose elevated GLP-1, GIP, insulin and glucose and delayed gastric emptying. Sucralose (0.4mM* & 4mM) did not differ from the saline controls. *[= 168 ppm, approx. the amount in a diet soft drink]
29 Recent Clinical Studies 2. Ma et al (2010): measured GLP-1, glucose and OMG in 10 healthy subjects after intraduodenal infusion of glucose, sucralose (4mM) and OMG to evaluate whether sucralose exposure of the upper GI tract will increase the rate of glucose absorption and glycaemic response. Result:: sucralose did not modify the rate of glucose absorption or the glycaemic or incretin response to ID infusion when given acutely to healthy subjects.
30 Recent Clinical Studies 3. Ford et al (2011) investigated whether oral ingestion of sucralose, at a dose level consistent with a normal diet (2 mm), increases circulating GLP-1 or PYY concentrations in 8 healthy volunteers. This was a randomized, single-blind, crossover study conducted on 4 separate days. Results: sucralose ingestion did not increase plasma GLP- 1 or PYY concentrations. MSF of sucralose did not elicit a cephalic response for insulin or GLP-1. The control, maltodextrin, significantly increased insulin and blood glucose vs water. Appetite and energy intake was similar for all groups.
31 Recent Clinical Studies 4. Steinert et al (2011), investigated the human gut response to LCS (APM, AC-K, sucralose) and sugars (glu, fruc, 2-DG) using solutions that were iso-sweet. Solutions were administered IG in a placebo-controlled, double-blind, six-way, cross-over trial using 12 healthy subjects. Results: LCS did not affect GI peptide secretion (GLP-1, PYY & ghrelin) and had minimal effect on appetite. These investigators conclude that stimulation of gut sweet taste receptors per se is not sufficient to produce regulatory peptide responses.
32 Conclusions (1) The data used to support the speculation that LCS interact with the GI taste receptors to increase incretin secretion, and, consequently, increase glucose absorption are derived from elegant molecular biology experiments using short-term in vitro tissue culture systems and rodent model systems to define the receptor site of the enteroendocrine cells.
33 Conclusions (2) There are very extensive databases demonstrating the safety and efficacy of each LCS from which relevant data can be drawn. Had LCS induced the derangements in glucose homeostasis predicted by Egan/Margolskee hypothesis, they would have manifest themselves in the preclinical and clinical safety studies.
34 Conclusions (3) An increasing number of clinical studies have been recently published that specifically test the Egan/Margolskee hypothesis and none has, as of this date, supported the concept that LCS are nutritionally active in a way that is clinically significant. There is no consistent evidence that LCS cause insulin release or lower blood sugar when ingested.
Actions of Hormones on Target Cells Graphics are used with permission of: Pearson Education Inc., publishing as Benjamin Cummings (http://www.aw-bc.com) Page 1. Actions of Hormones on Target Cells Hormones
Neural Systems Involved in Food Intake: An Integrative Overview Stephen C. Woods* Department of Psychiatry and Behavioral Neuroscience University of Cincinnati * No conflicts to report ILSI North America
Subcutaneous Infusion of GLP-1 for 7 Days Improves Glycemic Control Over a Broad Dose Range in Patients with Type 2 Diabetes Mario R. Ehlers, 1,2 Roderick E. Harley, 1 Annette L. Mathisen, 1 Roberta Schneider,
Guidance for Industry Food-Effect Bioavailability and Fed Bioequivalence Studies U.S. Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and Research (CDER)
The Key to Natural Weight Management Support Presented by Sabinsa Corporation LeanGard A bioavailable combination of natural ingredients that addresses multiple targets in weight management: Supports Lean
Calculating and Graphing Glucose, Insulin, and GFR HASPI Medical Biology Activity 19c Name: Period: Date: Part A Background The Pancreas and Insulin The following background information has been provided
Endocrine System: Practice Questions #1 1. Removing part of gland D would most likely result in A. a decrease in the secretions of other glands B. a decrease in the blood calcium level C. an increase in
Regulation of carbohydrate metabolism Intracellular metabolic regulators Each of the control point steps in the carbohydrate metabolic pathways in effect regulates itself by responding to molecules that
Comparative Studies and Metabolic Effects of Sleeve Gastrectomy Alfonso Torquati MD, MSCI Associate Professor of Surgery Discosures NIH-NIDDK: grant support Covidien: consulting agreement, grant support
Surgical Treatment of Obesity: A Surgeon s View Jenny J. Choi, MD Director of Bariatrics Associate Director of Clinical Affairs Assistant Professor of Surgery Albert Einstein School of Medicine Montefiore
New Treatments for Type 2 Diabetes Dr David Hopkins Clinical Director, Division of Ambulatory Care King s College Hospital NHS Foundation Trust Treatments for type 2 diabetes - old & new insulin sulphonylureas
Clinical Trial Results Database Page 1 Sponsor Novartis Generic Drug Name Vildagliptin Therapeutic Area of Trial Type 2 diabetes Approved Indication Investigational Study Number CLAF237A2386 Title A single-center,
Chapter 25: Metabolism and Nutrition Chapter Objectives INTRODUCTION 1. Generalize the way in which nutrients are processed through the three major metabolic fates in order to perform various energetic
New and Future Treatments for Diabetes Mary Charlton Specialty Doctor in Diabetes University Hospital Birmingham BARS Oct 2014 Conflicts of interest Investigator Carmelina study of Linagliptin (Boehringer
Introduction to Enteris BioPharma Enteris BioPharma Intelligent Solutions for Oral Drug Delivery Privately held, New Jersey based biotech company Owned solely by Victory Park Capital, a large Chicago based
Cancer treatment and diabetes Dr Daniel Morganstein Consultant Endocrinologist, 1 2 Diabetes and cancer Cancer and its treatment also poses challenges to managing diabetes Surgery Altered appetite Cachexia
Diabetes mellitus Lecture Outline I. Diagnosis II. Epidemiology III. Causes of diabetes IV. Health Problems and Diabetes V. Treating Diabetes VI. Physical activity and diabetes 1 Diabetes Disorder characterized
Weight Loss urgery and Bariatric Nutrition Jeanine Giordano, M, RD, CDN UA: Mean BMI trends (age standardized) Prevalence of Obesity Among Adults United tates 68% Australia 59% Russia 54% United Kingdom
7 Answers to end-of-chapter questions Multiple choice questions 1 B 2 B 3 A 4 B 5 A 6 D 7 C 8 C 9 B 10 B Structured questions 11 a i Maintenance of a constant internal environment within set limits i Concentration
Metabolic Pathways - absorptive GI tract Hormonal Control of Blood Triglyceride Amino Acids α-ketoacids protein All tissue adipose Metabolic Pathways - postabsorptive Lactate & pyruvate protein Lactate
The Effect of Sucralose on 2-hour Postprandial Glucose and Insulin in Non-diabetic Overweight Subjects Teerapat Wutirakchaiyanan 1 Dr.KarntWongsuphasawat, PhD 2 ABSTRACT Sucralose is an artificial non-caloric
PowerPoint Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY 12a FOCUS ON Your Risk for Diabetes Your Risk for Diabetes! Since 1980,Diabetes has increased by 50 %. Diabetes has increased by 70 percent
Page 1 DRUGS FOR GLUCOSE MANAGEMENT AND DIABETES Drugs to know are: Actrapid HM Humulin R, L, U Penmix SUNALI MEHTA The three principal hormones produced by the pancreas are: Insulin: nutrient metabolism:
Nursing 113 Pharmacology Principles 1. The study of how drugs enter the body, reach the site of action, and are removed from the body is called a. pharmacotherapeutics b. pharmacology c. pharmacodynamics
All about Stevia What is Stevia? Stevia is a small shrub native to the region of South America where the borders of Paraguay, Argentina, and Brazil meet. The scientific name for stevia is Stevia rebaudiana
HEALTH CLAIMS ON PECTINS APPROVED BY EFSA Scientific Opinion on the substantiation of health claims related to pectins and reduction of post-prandial glycaemic responses (ID 786) and maintenance of normal
Does Metabolic Surgery The combination of type 2 diabetes and being significantly overweight is a huge burden. Doctors tell you to lose weight, in essence, to save your life. Weight loss, in addition to
1 Pharmaceutical Management of Diabetes Mellitus Diabetes Mellitus (cont d) Signs and symptoms 2 Elevated fasting blood glucose (higher than 126 mg/dl) or a hemoglobin A1C (A1C) level greater than or equal
It s time to TALK Targets A guide to taking control of your type 2 diabetes The TALK Targets campaign was initiated and fully funded by Novo Nordisk. By supporting you and your healthcare team, TALK Targets
Reactive Hypoglycemia- is it a real phenomena among endurance athletes? by Dr. Trent Stellingwerff, PhD Are you an athlete that periodically experiences episodes of extreme hypoglycemia (low blood sugar)
Absorption of Drugs Absorption is the transfer of a drug from its site of administration to the bloodstream. The rate and efficiency of absorption depend on the route of administration. For IV delivery,
BCM 101 BIOCHEMISTRY Week 3 Practical Colorimetric determination of blood sugar level _ In medicine, blood sugar is a term used to refer to the level of glucose in blood. Glucose, transported via the bloodstream,
Why? Control of Sugar Levels What hormones are involved in the homeostasis of blood sugar? All living things use as a source of energy. In vertebrates it is critical that the levels of in the blood are
Senior Professor Göran Petersson May 2013 Chemical- and Biological Engineering, Chalmers University of Technology, Göteborg, Sweden FAST CARBOHYDRATES INSULIN RESISTANCE DIABETES 2 OBESITY Low-Carb Diets
Frequently Asked Questions General Product 1. What is this product? Nutrilite Slimmetry dietary supplement offers a way to supplement the diet with caffeine-free green tea extract that is designed to help
Overview Harmony is the global Phase III clinical trial program for Tanzeum (albiglutide), a product developed by GSK for the treatment of type 2 diabetes. The comprehensive program comprised eight individual
A current and global review of sweeteners; regulatory aspects J. M. García-Almeida 1, Gracia M.ª Casado Fdez. 2 and J. García Alemán 1 Nutr Hosp 2013;28(Supl. 4):17-31 ISSN (Versión papel): 0212-1611 ISSN
Animals: Digestion and Nutrition Do you like pizza? Digestion and Nutrition Let s s eat something 1 Enjoy eating 1. Key concepts 2. Nutrition Outline 3. Comparison of different animals digestive systems
ADJUNCTIVE THERAPIES FOR TYPE 1 DIABETES Dr. Mohammad Alhadj Ali, MD, PgDip, MSc, PhD (UK) with Prof. David Owens (UK) Outline Type 1 Diabetes Immunology of Type 1 Diabetes Treatment of Type 1 Diabetes
Central Florida Research Update Ayala, Julio, PhD, Sanford-Burnham Medical Research Institute, Orlando, Florida Anorectic Mechanisms of Glp1r Agonists Obesity Jan 1, 2014 Dec 31, 2018 Integrated Physiology,
THE ROLE OF TUMOUR NECROSIS FACTOR ALPHA (TNFa) IN OBESITY Alison Mary Morris, B.Sc (Hons) A thesis submitted to Adelaide University for the degree of Doctor of Philosophy Department of Physiology Adelaide
Metabolism Functions of food source of energy essential nutrients Metabolism is all the chemical reactions of the body some reactions produce the energy stored in ATP that other reactions consume all molecules
Effect of on Blood Glucose Levels in Alloxan-induced Diabetic Mice Kathryn Niedzielski Advisor: Dr. Linda Swift ABSTRACT Diabetes is a condition in the body where the pancreas does not produce enough insulin
Hormones & Chemical Signaling Part 2 modulation of signal pathways and hormone classification & function How are these pathways controlled? Receptors are proteins! Subject to Specificity of binding Competition
Week 30 Water Balance and Minerals Water: more vital to life than food involved in almost every body function is not stored--excreted daily largest single constituent of the human body, averaging 60% of
Enhanced Absorption Patented Delivery System A New Bioavailability Platform The bioavailability of a nutritional ingredient is a vital determinant of clinical efficacy. As part of a long-standing philosophy
Lipid Metabolism 1. What has a higher stored energy potential per gram, glycogen or triglycerides? Explain. 2. How can excess acetyl CoA trapped in the mitochondria, be utilized as a substrate for fatty
Digestive System Functions A. Gastrointestinal Processes 1. Ingestion: placing food in mouth (voluntary) 2. Propulsion: moving food through GI tract a. Peristalsis: alternating waves of contraction and
Chapter 4 Type 2 Diabetes (previously referred to as adult onset diabetes or non-insulin dependent diabetes) H. Peter Chase, MD Cindy Cain, RN, CDE Philip Zeitler, MD This is the most common type of diabetes
Treatment Approaches to Diabetes Dr. Sarah Swofford, MD, MSPH & Marilee Bomar, GCNS, CDE Quick Overview Lifestyle Oral meds Injectables not insulin Insulin Summary 1 Lifestyle & DM Getting to the point
Update on diabetes care and therapy Tunde Peto Head of Reading Centre Case 1: 39 year old male, works as bricklayer Type 1 diabetes diagnosed 29 years ago BMI: 27 kg/m HbA1c: 8.5% Cholesterol: 6 mmol/l
Healthy Weight Loss Program NEW! SlimStyles PGX Granules SlimStyles PGX SlimStyx: Available in convenient single-serving Slimstyx packets (2.5 g each) All the products in this brochure are available at
Dealing with weight regain after Rouxen-Y gastric bypass: surgical approach Robin Blackstone, MD, FACS Masters of Minimally Invasive Bariatric Surgery April 5, 2013 Orlando, Florida Disclosures PI Enteromedics
Digestion, Absorption How & where? What happens to food? Three processes Digestion Absorption Elimination Where do they occur? GI tract Overview of Digestion GI tract Gastrointestinal (GI) tract: series
Effect of liraglutide on body weight in overweight or obese subjects with type 2 diabetes: SCALE - Diabetes This trial is conducted in Africa, Asia, Europe and the United States of America (USA). The aim
International Journal of Pharma and Bio Sciences REVIEW ARTICLE PHARMACOLOGY LINAGLIPTIN- A NOVEL DPP-IV INHIBITOR Corresponding Author N.PRABAVATHY Department of Pharmacology, Mother Theresa Post Graduate
THE DIGESTIVE SYSTEM Topic 2: Control of the Digestive System Graphics are used with permission of: Pearson Education Inc., publishing as Benjamin Cummings (http://www.aw-bc.com) Page 1: Title Page The
INSULIN AND INCRETIN THERAPIES: WHAT COMBINATIONS ARE RIGHT FOR YOUR PATIENT? MARTHA M. BRINSKO, MSN, ANP-BC CHARLOTTE COMMUNITY HEALTH CLINIC CHARLOTTE, NC Diagnosed and undiagnosed diabetes in the United
Cardiovascular Disease Risk Factors Part XII By James L. Holly, MD Your Life Your Health The Examiner September 15, 2005 As we approach the end of our extended series on cardiovascular disease risk factors,
X-Plain Hypoglycemia Reference Summary Introduction Hypoglycemia is a condition that causes blood sugar level to drop dangerously low. It mostly shows up in diabetic patients who take insulin. When recognized
Department Of Biochemistry Subject: Diabetes Mellitus Supervisor: Dr.Hazim Allawi & Dr.Omar Akram Prepared by : Shahad Ismael. 2 nd stage. Diabetes mellitus : Type 1 & Type 2 What is diabestes mellitus?
Title: Protein Intake in Potentially Insulin Resistant Adults: Impact on Glycemic and Lipoprotein Profiles - NPB #01-075 Investigator: Institution: Gail Gates, PhD, RD/LD Oklahoma State University Date
Give a NOD to diabetes: NOD proteins ti link immunity it and metabolism tbli Jonathan Schertzer McMaster University McMaster University Faculty of Health Sciences Department of Biochemistry and Biomedical
Aloe vera L. Simply, the most extensively tested Aloe vera available Aloecorp, Inc International Aloe Science Council Certified Facility and Products Qmatrix The GRAS Ingredient A Highly Purified Fraction
RESEARCH Review Meets Learning Need Codes 5000, 5370, and 5390. To take the Continuing Professional Education quiz for this article, log in to ADA s Online Business Center at www.eatright.org/obc, click
Causes, incidence, and risk factors Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes,
THE DIGESTIVE SYSTEM What is digestion? Digestion is the process of breaking down food so that it's small enough to be absorbed and used by the body for energy or in other bodily functions. Digestion involves
Introduction Type 2 diabetes mellitus (t2dm) is the most prevalent form of diabetes worldwide. It is characterised by high fasting and high postprandial blood glucose concentrations (hyperglycemia). Chronic
Glucagon Receptor Antagonist: LGD-6972 Program Overview and Phase 1b Results American Diabetes Association s 75th Scientific Sessions June 7, 2015 Boston 2 Safe Harbor Statement The following presentation
Page 1 of 5 Type 2 Diabetes Type 2 diabetes occurs mainly in people aged over 40. The 'first-line' treatment is diet, weight control and physical activity. If the blood glucose level remains high despite
Lec.13 Medical Physiology Z.H.Al-Zubaydi Functions of the Digestive System The major functions of the digestive tract include the following six processes, summarized in Figure 1: 1. Ingestion Food must
The Background for the Diabetes Detection Model James K. Peterson Department of Biological Sciences and Department of Mathematical Sciences Clemson University November 23, 2014 Outline The Background for
GLYCAEMIC INDICES OF DIFFERENT SUGARS Uma P., Hariharan R.S., Ramani V. and Seshiah V. Dietary advice to diabetic patients has conventionally included restriction of readily absorbable simple sugars. l
A Calorie is a Calorie Or is It? 6 th Biennial Childhood Obesity Conference, June 30, 2011 Jeff S. Volek, Ph.D., R.D. Human Performance Laboratory Department of Kinesiology University of Connecticut Storrs,
Unit 3 Lecture METABOLISM Anabolism is defined as the chemical reactions that combine simple substances into more complex molecules (requires energy). Examples of anabolism include glycogenesis (conversion
Digestion, Absorption How & where? What happens to food? Three processes Digestion Absorption Elimination Where do they occur? GI tract Overview of Digestion GI tract Gastrointestinal (GI) tract: series
TYPE 2 DIABETES IN CHILDREN DIAGNOSIS AND THERAPY Ines Guttmann- Bauman MD Clinical Associate Professor, Division of Pediatric Endocrinology, OHSU Objectives: 1. To discuss epidemiology and presentation
The Polyphenol Study Effect of Dietary Polyphenols on Intestinal Microbiota, Intestinal Inflammation and Metabolic Syndrome Principal Investigator: Michael Lefevre, PhD What are Polyphenols? * Polyphenols
Diagnosing Diabetes Teacher information Summary: Students analyze simulated blood plasma samples collected during a glucose tolerance test for diabetes. They test glucose and insulin levels to determine
OpenStax-CNX module: m49457 1 Digestive System Module 7: Chemical Digestion and Absorption: A Closer Look Donna Browne Based on Chemical Digestion and Absorption: A Closer Look by OpenStax This work is
Clinical Care/Education/Nutrition/Psychosocial Research O R I G I N A L A R T I C L E Effects of Diet Soda on Gut Hormones in Youths With Diabetes REBECCA J. BROWN, MD, MHSC MARY WALTER, PHD KRISTINA I.
General Psychology 202 Motivation and Emotion LP 9A Theories of motivation 1 Prologue: One Step at a Time Introduction: Motivation and Emotion Motivation Concepts and Theories Instinct theories: Inborn
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this
Omega-3 Bioavailability: Is One Form of Omega-3 More Bioavailable than Another? By Bruce Holub and Jennifer Grebow, Nutrional Outlook: November 11, 2011. Contact Information: Bruce J. Holub, PhD University
BIOZONE Assignment #2 Cell Membrane Transport PASSIVE TRANSPORT PROCESSES 1. Describe two properties of an exchange surface that would facilitate rapid diffusion rates*: (a) thin membrane (b) porous membrane
Introduction to Body Fluids Graphics are used with permission of: Pearson Education Inc., publishing as Benjamin Cummings (http://www.aw-bc.com) Page 1: Introduction to Body Fluids The fluids in your body
Homeostatic Model Assessment (HOMA) Historically, insulin resistance (IR) was measured with an invasive test called a euglycemic clamp test. Basically it s a test to measure how much insulin a person needs
One of the most remarkable examples of cell communication is the fight or flight response. When a threat occurs, cells communicate rapidly to elicit physiological responses that help the body handle extraordinary