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Maternal Insulin Resistance And Transient Hyperglycemia Impact The Metabolic And Endocrine Phenotypes Of Offspring

Maternal insulin resistance and transient hyperglycemia impact the metabolic and endocrine phenotypes of offspring Section of Islet Cell and Regenerative Biology, Joslin Diabetes Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts *S. Kahraman and E. Dirice contributed equally to this article. Address for reprint requests and other correspondence: R. N. Kulkarni, Joslin Diabetes Center and Harvard Medical School Boston, MA 02215 (e-mail: [email protected] ). Received 2014 May 7; Accepted 2014 Sep 9. Copyright 2014 the American Physiological Society This article has been cited by other articles in PMC. Studies in both humans and rodents suggest that maternal diabetes leads to a higher risk of the fetus developing impaired glucose tolerance and obesity during adulthood. However, the impact of hyperinsulinemia in the mother on glucose homeostasis in the offspring has not been fully explored. We aimed to determine the consequences of maternal insulin resistance on offspring metabolism and endocrine pancreas development using the LIRKO mouse model, which exhibits sustained hyperinsulinemia and transient increase in blood glucose concentratio Continue reading >>

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  1. Zanshin

    I read a couple of posts on here about this, and I`m not convinced. I tested my blood sugar at 4:50pm today, it was 10.1. A little high, but I didn`t think it warranted extra insulin, as I was going to an MMA conditioning class so couldn`t be sure how fast it might drop. The class was 5:15 to 6:15, it was (I think) a bit of aerobic exercise followed by anaerobic. I got home and tested at 7pm, and my levels had risen to 20!
    What`s the story? I read somewhere that anaerobic exercise can lead to production of lactate which makes levels rise? What should I have done, taken insulin pre training? Anyone understand the underlying science?
    Any advice appreciated!

  2. mc-

    Sometimes if insulin levels are high before you exercise, they can stay high if you're not working at a heart rate level high enough to be burning up the blood/muscle glucose that's circulating
    The lactate/insulin connection is interesting: lactate is used as a substrate for energy - so it's a good thing. We tap into it generally when we're working at the threshold of aerobic (fat burning/oxygen use) and anaerobic (doesn't need oxygen to burn, so phosphate, glucose and lactate metabolism go in here).
    A paper in 2002 suggested that lactate was a big insulin resistance inducer - so no getting glucose into the cell with lactate around (AJP-Endo Articles in PresS. Published on April 30, 2002 as DOI 10.1152/ajpendo.00557.2001) But more recently, work shows that lactate suppresses glycolosis (conversion of glucose into pyruvate for ATP - in short conversion of glucose into energy) not insulin uptake.
    THis makes sense to me: one does lactate threshold training in endurance in order to be "glycogen sparing" - to be able to up the aerobic threshold (ability to rely on fat as fuel before cracking into the faster used up sugar supplies). Intriguingly, lactate is a by-product of anaerobic fuel burning that feeds back into the aerobic system for fuel. The better the aerobic system can utilize lactate the more effective and efficient and usually powerful it is.
    So, a paper in 2008 (EFFECT OF LACTATE ON INSULIN ACTION IN RATS) also looking at rodents showed that simultaneous exposure of insulin and lactate in the rats resulted in way more glucose uptake (which would suggest improved insulin sensitivity). That's a good thing.
    Related - a recent paper (http://www.ncbi.nlm.nih.gov/pmc/article ... ool=pubmed) shows that working at lactate thresholod can be a good way to improve insulin senstivity. BUT also low instensity aerobic work reduced IGF (insulin like growth factor 1) and increased circulating IGFbp (igf binding proteins).
    SO - bottom line seems to be that, if muscles are working hard enough to say i'm running out of fuel; stick more glucose into me please, then glucose levels go up but genearlly speaking that elevation is going to come down after the demand has been satisfied unless the levels were a bit oversaturated to begin with.
    Lactate is a good thing that should not interfere with insulin but may reduce the need for glycolosis - thus that extra load may be floating around in the blood stream. And of course if you had any kind of recovery drink during or after the bout that will add too.
    Does that help? clear as mud?

  3. Zanshin

    That`s a really useful reply, thanks for that. Interesting too - I think the article I read about lactate suggested that, whilst training aerobically, if your blood sugar starts to fall (as you`d intuitively expect after a while), a short spell of anaerobic work could potentially be used to prevent hypoglycaemia via lactate production. I`m not entirely convinced, but it sort of sounds right based on some blood sugar readings I`ve had before and after specific training sessions.
    I guess the hard question is, when my blood sugar is at the high end of normal (eg around 10), what do I do before training? One option would be to take a small insulin dose of say 3 units, and possibly a biscuit or apple or similar. I`ve done this before, but it always feels wrong to take insulin before training, as on the few occasions when it has brought on a hypo, I`ve felt completely stupid!

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