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Disturbances in Dynamics of Glucose, Insulin, and C-Peptide in Blood after a Normalized Intake of a Mixed Meal in Obesity and Type 2 Diabetes Mellitus

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Abstract

The aim of the study was to investigate the dynamics of venous blood glucose, insulin, and C-peptide in response to an intake of a mixed meal normalized to body mass in obese patients without and with type 2 diabetes mellitus. Venous blood samples were taken from seven healthy subjects, nine obese patients, and ten obese patients with type 2 diabetes mellitus (mean duration of diabetes 7 years) before and 30, 60, 90, 120, and 180 min after a mixed meal (6 kcal/kg of body mass); additionally, nine patients with obesity and type 2 diabetes mellitus and three healthy volunteers completed the hyperinsulinemic-euglycemic clamp test. In patient groups the energy content of food did not differ but was 1.8 times higher than in the control. An increase in glucose level 1 h after a meal was maximal in patients with type 2 diabetes, and an increase in insulin and C-peptide was higher in obese patients, which is related to impairment of insulin-dependent glucose uptake by tissues and of the rate of insulin secretion (dysfunction of beta-cells) in patients. At the same time, an increase in the total area under the curve “C-peptide–time” demonstrates that the maximal secretory response of beta-cells is comparable in obese patients without and with type 2 diabetes mellitus. The absolute blood glucose level 90 min after a meal closely correlated with the M-index—the marker of systemic sensitivity to insulin (rs = –0.82, p = 0.002). Our results characterize the features in the regulation of carbohydrate metabolism after intake of a mixed meal, normalized to body mass, in people with varying severity of metabolic disorders, and open up prospects for a wider application of this test in practice.

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ACKNOWLEDGMENTS

The authors are grateful to Ph.D. I.A. Sklyanik (Institute of Diabetes, State Scientific Center of the Russian Federation, Federal State Budgetary Institution “NMITs of Endocrinology,” Ministry of Health of Russia, Moscow) for his help in working with patients.

Funding

The study was supported by the Russian Science Foundation (grant no. 21-75-10 146).

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Authors and Affiliations

  1. Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia

    E. M. Lednev, T. F. Vepkhvadze, P. A. Makhnovskii & D. V. Popov

  2. National Medical Research Center for Endocrinology, Moscow, Russia

    E. M. Lednev, A. O. Gavrilova & M. V. Shestakova

  3. Moscow State University, Moscow, Russia

    T. F. Vepkhvadze & D. V. Popov

Authors
  1. E. M. Lednev
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  2. A. O. Gavrilova
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  3. T. F. Vepkhvadze
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  4. P. A. Makhnovskii
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  5. M. V. Shestakova
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  6. D. V. Popov
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Corresponding author

Correspondence to D. V. Popov.

Ethics declarations

All studies were conducted in accordance with the principles of biomedical ethics as formulated in the 1964 Declaration of Helsinki and its subsequent updates and approved by the Biomedical Ethics Committee of the Institute of Biomedical Problems of the Russian Academy of Sciences (Moscow), No. 613 of March 29, 2022 and the Local Ethics Committee of the National Medical Research Center for Endocrinology (Moscow), No. 4 of February 14, 2022.

Each participant in the study provided a voluntary written informed consent signed by him after explaining to him the potential risks and benefits, as well as the nature of the upcoming study.

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The authors of this work declare that they have no conflicts of interest.

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Lednev, E.M., Gavrilova, A.O., Vepkhvadze, T.F. et al. Disturbances in Dynamics of Glucose, Insulin, and C-Peptide in Blood after a Normalized Intake of a Mixed Meal in Obesity and Type 2 Diabetes Mellitus. Hum Physiol 49, 668–674 (2023). https://doi.org/10.1134/S0362119723600297

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  • DOI: https://doi.org/10.1134/S0362119723600297

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