Document Detail


Validity of triple- and dual-tracer techniques to estimate glucose appearance.
MedLine Citation:
PMID:  22454288     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The triple-tracer (TT) dilution technique has been proposed to be the gold standard method to measure postprandial glucose appearance. However, validation against an independent standard has been missing. We addressed this issue and also validated the simpler dual-tracer (DT) technique. Sixteen young subjects with type 1 diabetes (age 19.5 ± 3.8 yr, BMI 23.4 ± 1.5 kg/m(2), HbA(1c) 8.7 ± 1.7%, diabetes duration 9.0 ± 6.9 yr, total daily insulin 0.9 ± 0.2 U·kg(-1)·day(-1), mean ± SD) received a variable intravenous 20% dextrose infusion enriched with [U-(13)C]glucose over 8 h to achieve postprandial-resembling glucose excursions while intravenous insulin was administered to achieve postprandial-resembling levels of plasma insulin. Primed [6,6-(2)H(2)]glucose was infused in a manner that mimicked the expected endogenous glucose production and [U-(13)C; 1,2,3,4,5,6,6-(2)H(7)]glucose was infused in a manner that mimicked the expected glucose appearance from a standard meal. Plasma glucose enrichment was measured by gas chromatography-mass spectrometry. The intravenous dextrose infusion served as an independent standard and was reconstructed using the TT and DT techniques with the two-compartment Radziuk/Mari model and an advanced stochastic computational method. The difference between the infused and reconstructed dextrose profile was similar for the two methods (root mean square error 6.6 ± 1.9 vs. 8.0 ± 3.5 μmol·kg(-1)·min(-1), TT vs. DT, P = NS, paired t-test). The TT technique was more accurate in recovering the overall dextrose infusion (100 ± 9 and 92 ± 12%; P = 0.02). The root mean square error associated with the mean dextrose infusion profile was 2.5 and 3.3 μmol·kg(-1)·min(-1) for the TT and DT techniques, respectively. We conclude that the TT and DT techniques combined with the advanced computational method can measure accurately exogenous glucose appearance. The TT technique tends to outperform slightly the DT technique, but the latter benefits from reduced experimental and computational complexity.
Authors:
A Haidar; D Elleri; J M Allen; J Harris; K Kumareswaran; M Nodale; C L Acerini; M E Wilinska; N Jackson; A M Umpleby; M L Evans; D B Dunger; R Hovorka
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-03-27
Journal Detail:
Title:  American journal of physiology. Endocrinology and metabolism     Volume:  302     ISSN:  1522-1555     ISO Abbreviation:  Am. J. Physiol. Endocrinol. Metab.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-18     Completed Date:  2012-08-27     Revised Date:  2013-04-16    
Medline Journal Info:
Nlm Unique ID:  100901226     Medline TA:  Am J Physiol Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E1493-501     Citation Subset:  IM    
Affiliation:
Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Algorithms
Area Under Curve
Blood Glucose / metabolism
Carbon Radioisotopes / chemistry,  diagnostic use
Data Interpretation, Statistical
Deuterium / chemistry,  diagnostic use
Female
Gas Chromatography-Mass Spectrometry
Glucose / metabolism*,  pharmacology
Hemoglobin A, Glycosylated / analysis
Humans
Infusions, Intravenous
Insulin / blood
Intestinal Absorption
Isotope Labeling
Least-Squares Analysis
Male
Radioactive Tracers*
Radioisotope Dilution Technique*
Reproducibility of Results
Stochastic Processes
Young Adult
Grant Support
ID/Acronym/Agency:
1R01 DK-085621/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Carbon Radioisotopes; 0/Hemoglobin A, Glycosylated; 0/Insulin; 0/Radioactive Tracers; 50-99-7/Glucose; 7782-39-0/Deuterium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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