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| Name | Class |
|---|---|
| Deakin University | OTHER |
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Insulin resistance (or pre-diabetes) is diagnosed using the oral glucose tolerance test. However, high blood glucose levels during this test may adversely impact on microvascular function. Investigators will determine whether a liquid mixed meal challenge (from carbohydrate, protein and fat) is a more appropriate test for assessing microvascular-derived insulin resistance.
After consuming a meal, 80% of glucose is disposed in skeletal muscle. Our research group has demonstrated that microvascular blood flow in skeletal muscle plays an integral role in this process. Physiological doses of insulin stimulate microvascular blood flow, and that this increase is associated with enhanced glucose uptake by muscle. This microvascular action of insulin is lost during insulin resistance and type 2 diabetes.
The oral glucose tolerance test (GTT) is the gold standard for assessing insulin resistance and pre-diabetes and is used world-wide. However high blood glucose levels following a glucose load may adversely impact on microvascular function. The aim of this project is to determine whether a mixed meal challenge (liquid drink consisting of carbohydrate, fat and protein) is a better test for assessing microvascular-derived insulin resistance.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mixed Meal Challenge | Experimental | Participants will consume a liquid mixed meal (~300 calories - fat, carbohydrate, and protein) for monitoring changes in glucose metabolism, plasma insulin and microvascular responses in skeletal muscle over 2 hours. |
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| Glucose Challenge | Active Comparator | Participants will consume a glucose challenge (50g glucose) for monitoring changes in glucose metabolism, plasma insulin and microvascular responses in skeletal muscle over 2 hours. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mixed Meal Challenge | Other | Liquid mixed meal (300 calories - fat, carbohydrate, and protein). |
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| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in muscle microvascular blood flow | Microvascular responses will be measured by contrast enhanced ultrasound before and 1hr after each challenge. | 1 hr |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in blood glucose levels | Blood glucose levels will be measured at 0, 15, 30, 60, 90 and 120 min following each challenge. | 2 hr |
| Changes in plasma insulin levels | Plasma insulin levels will be measured at 0, 15, 30, 60, 90 and 120 min following each challenge. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Michelle A Keske, PhD | Menzies Institute for Medical Research | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Menzies Institute for Medical Research | Hobart | Tasmania | 7000 | Australia | ||
| Deakin University |
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| ID | Term |
|---|---|
| D007333 | Insulin Resistance |
| ID | Term |
|---|---|
| D006946 | Hyperinsulinism |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| Glucose Challenge | Other | Glucose drink (50g glucose) |
|
| 2hr |
| Changes in the respiratory exchange ratio (RER) | Changes in RER will be measured by metabolic cart during each challenge. | 1 hr |
| Burwood |
| Victoria |
| 3125 |
| Australia |