Abstract
Chronic mild metabolic acidosis is common among older adults, and limited evidence suggests that it may contribute to insulin resistance and type-2 diabetes. This analysis was conducted to determine whether bicarbonate supplementation, an alkalinizing treatment, improves insulin sensitivity or glucose control in non-diabetic older adults. Fasting blood glucose and insulin were measured in stored samples from subjects who had completed a 3-month clinical trial of bicarbonate supplementation to improve indicators of bone and muscle health. One hundred and fifty three ambulatory, non-diabetic adults aged 50 years and older were studied. Subjects were randomized to one of two bicarbonate groups (67.5 mmol/day of potassium bicarbonate or sodium bicarbonate) or to one of two no-bicarbonate groups (67.5 mmol/day of placebo or potassium chloride). Subjects remained on treatment throughout the 3-month study. The primary outcome measures were changes in fasting plasma glucose, serum insulin and HOMA-IR, an index of insulin resistance. Bicarbonate supplementation reduced net acid excretion (adjusted mean ± SEM for the change in NAE/creatinine, mmol/mmol, was 0.23 ± 0.22 in the no-bicarbonate group compared with −3.53 ± 0.22 in the bicarbonate group, P < 0.001) but had no effect on fasting plasma glucose, serum insulin, or HOMA-IR. In conclusion, bicarbonate supplementation does not appear to improve insulin sensitivity or glucose control in non-diabetic older adults.
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References
L.A. Frassetto, R.C. Morris Jr., A. Sebastian, Am. J. Physiol. 271, F1114–F1122 (1996)
R.J. Alpern, K. Sakhaee, Am. J. Kidney Dis. 29, 291–302 (1997)
A. Sebastian, R.C. Morris Jr., N. Engl. J. Med. 331, 279 (1994)
L. Frassetto, R.C. Morris Jr., A. Sebastian, J. Clin. Endocrinol. Metab. 82, 254–259 (1997)
M.F. McCarty, Med. Hypotheses 64, 380–384 (2005)
R.A. DeFronzo, A.D. Beckles, Am. J. Physiol. 236, E328–E334 (1979)
W.R. Farwell, E.N. Taylor, Diabet. Med. 25, 798–804 (2008)
B. Dawson-Hughes, S.S. Harris, N.J. Palermo, C. Castaneda-Sceppa, H.M. Rasmussen, G.E. Dallal, J. Clin. Endocrinol. Metab. 94, 96–102 (2009)
B. Dawson-Hughes, C. Castaneda-Sceppa, S.S. Harris, N.J. Palermo, G. Cloutier, L. Ceglia, G.E. Dallal, Osteoporos. Int. (2009)
R.A. Washburn, K.W. Smith, A.M. Jette, C.A. Janney, J. Clin. Epidemiol. 46, 153–162 (1993)
G. Block, M. Woods, A. Potosky, C. Clifford, J. Clin. Epidemiol. 43, 1327–1335 (1990)
K. Jorgensen, Scand. J. Clin. Lab. Invest. 9, 287–291 (1957)
J.C. Chan, Clin. Biochem. 5, 94–98 (1972)
D.R. Matthews, J.P. Hosker, A.S. Rudenski, B.A. Naylor, D.F. Treacher, R.C. Turner, Diabetologia 28, 412–419 (1985)
J.G. Toffaletti, E.H. McDonnell, Clin. Chim. Acta 395, 115–119 (2008)
M.A. McDowell, R.R. Briefl, K. Alaimo, A.M. Bischof, C.R. Caughman, M.D. Carroll, M.S. Loria, L.A. Johnson. Advance Data from Vital and Health Statistics, no 255. (National Center for Health Statistics, Hyattsville, MD, 1994)
M. Maurer, W. Riesen, J. Muser, H.N. Hulter, R. Krapf, Am. J. Physiol. Ren. Physiol. 284, F32–F40 (2003)
R.N. Bergman, Diabetes 38, 1512–1527 (1989)
A.M. Chang, M.J. Smith, C.J. Bloem, A.T. Galecki, J.B. Halter, M.A. Supiano, J. Clin. Endocrinol. Metab. 91, 629–634 (2006)
Acknowledgments
This study was supported by a grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (RO1 AR052322-01A1) and by contract 58-1950-7-707 with the Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University. This article does not necessarily reflect the views or policies of the US Department of Agriculture, nor does mention of trade names, commercial products, or organizations imply endorsement by the US government. The study is registered at ClinicalTrials.gov (NCT00357214). The authors thank Ms. Nancy Palermo and Ms. Stephanie Bostic of the Bone Metabolism Laboratory, Gayle Petty and staff of the Nutrition Evaluation Laboratory, staff of the Metabolic Research Unit, and the study participants for their invaluable contributions to this work.
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Harris, S.S., Dawson-Hughes, B. No effect of bicarbonate treatment on insulin sensitivity and glucose control in non-diabetic older adults. Endocr 38, 221–226 (2010). https://doi.org/10.1007/s12020-010-9377-6
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DOI: https://doi.org/10.1007/s12020-010-9377-6