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  • 1
    Online Resource
    Online Resource
    American Physiological Society ; 2004
    In:  American Journal of Physiology-Endocrinology and Metabolism Vol. 286, No. 4 ( 2004-04), p. E523-E528
    In: American Journal of Physiology-Endocrinology and Metabolism, American Physiological Society, Vol. 286, No. 4 ( 2004-04), p. E523-E528
    Abstract: Insulin stimulates muscle glucose disposal via both glycolysis and glycogen synthesis. Insulin activates glycogen synthase (GS) in skeletal muscle by phosphorylating PKB (or Akt), which in turn phosphorylates and inactivates glycogen synthase kinase 3 (GSK-3), with subsequent activation of GS. A rapamycin-sensitive pathway, most likely acting via ribosomal 70-kDa protein S6 kinase (p70 S6K ), has also been implicated in the regulation of GSK-3 and GS by insulin. Amino acids potently stimulate p70 S6K , and recent studies on cultured muscle cells suggest that amino acids also inactivate GSK-3 and/or activate GS via activating p70 S6K . To assess the physiological relevance of these findings to normal human physiology, we compared the effects of amino acids and insulin on whole body glucose disposal, p70 S6K , and GSK-3 phosphorylation, and on the activity of GS in vivo in skeletal muscle of 24 healthy human volunteers. After an overnight fast, subjects received intravenously either a mixed amino acid solution (1.26 μmol·kg -1 ·min -1 × 6 h, n = 9), a physiological dose of insulin (1 mU·kg -1 ·min -1 euglycemic hyperinsulinemic clamp × 2 h, n = 6), or a pharmacological dose of insulin (20 mU·kg -1 ·min -1 euglycemic hyperinsulinemic clamp × 2 h, n = 9). Whole body glucose disposal rates were assessed by calculating the steady-state glucose infusion rates, and vastus lateralis muscle was biopsied before and at the end of the infusion. Both amino acid infusion and physiological hyperinsulinemia enhanced p70 S6K phosphorylation without affecting GSK-3 phosphorylation, but only physiological hyperinsulinemia also increased whole body glucose disposal and GS activity. In contrast, a pharmacological dose of insulin significantly increased whole body glucose disposal, p70 S6K , GSK-3 phosphorylation, and GS activity. We conclude that amino acids at physiological concentrations mediate p70 S6K but, unlike insulin, do not regulate GSK-3 and GS phosphorylation/activity in human skeletal muscle.
    Type of Medium: Online Resource
    ISSN: 0193-1849 , 1522-1555
    Language: English
    Publisher: American Physiological Society
    Publication Date: 2004
    detail.hit.zdb_id: 1477331-4
    SSG: 12
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  • 2
    Online Resource
    Online Resource
    American Physiological Society ; 2006
    In:  American Journal of Physiology-Endocrinology and Metabolism Vol. 290, No. 6 ( 2006-06), p. E1191-E1197
    In: American Journal of Physiology-Endocrinology and Metabolism, American Physiological Society, Vol. 290, No. 6 ( 2006-06), p. E1191-E1197
    Abstract: Intense exercise and insulin each increases total limb blood flow and recruits muscle capillaries, presumably to facilitate nutrient exchange. Whether mixed meals or light exercise likewise recruits capillaries is unknown. We fed 18 (9 M, 9 F) healthy volunteers a 480-kcal liquid mixed meal. Plasma glucose, insulin, brachial artery flow, and forearm muscle microvascular blood volume were measured before and after the meal. Brachial artery flow and microvascular volume were also examined with light (25% max), moderate (50%), and heavy (80%) forearm contraction every 20 s in 5 (4 M, 1 F) healthy adults. After the meal, glucose and insulin rose modestly (to ∼7 mM and ∼270 pM) and peaked by 30 min, whereas brachial artery blood flow ( P 〈 0.05) and the microvascular volume ( P 〈 0.01) each increased significantly by 60 min, and microvascular flow velocity did not change. For exercise, both 50 and 80%, but not 25% maximal handgrip, increased average forearm and brachial artery blood flow ( P 〈 0.01). Flow increased immediately after each contraction and declined toward basal over 15 s. Exercise at 25% max increased microvascular volume threefold ( P 〈 0.01) without affecting microvascular flow velocity or total forearm blood flow. Forearm exercise at 80% maximal grip increased both microvascular volume and microvascular flow velocity ( P 〈 0.05 each). We conclude that light exercise and simple meals each markedly increases muscle microvascular volume, thereby expanding the endothelial surface for nutrient exchange, and that capillary recruitment is an important physiological response to facilitate nutrient/hormone delivery in healthy humans.
    Type of Medium: Online Resource
    ISSN: 0193-1849 , 1522-1555
    Language: English
    Publisher: American Physiological Society
    Publication Date: 2006
    detail.hit.zdb_id: 1477331-4
    SSG: 12
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  • 3
    In: Biological Research For Nursing, SAGE Publications, Vol. 7, No. 4 ( 2006-04), p. 279-288
    Abstract: The objective of this study was to determine the relationship of sociodemographics; diabetes-related factors, including diabetes-related microvascular complications; cardiac risk factors; and psychological factors with quality of life (QOL). Participants enrolled at three sites in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study were invited to participate in this ancillary study. Questionnaires assessing psychological factors were completed by participants, and the remainder of the data was obtained as part of the DIAD study. Many participants had elevated levels of anxiety (n = 91; 82%), depressive symptoms (n = 16; 14%), anger (n = 38; 34%), and hostility (n = 17; 17%). Results of multivariate analyses conducted for each of the eight domains on the Medical Outcomes Study Short Form-36 and two Diabetes Quality of Life domains demonstrated that in the majority of models (42% to 68% of the variance explained), female sex, peripheral or autonomic neuropathy, physical inactivity, higher body mass index, and the presence of depressive symptoms and anxiety were associated with poorer QOL (p = .0001). These findings demonstrate that anxiety, depressive symptoms, and neuropathy are prevalent in older adults with type 2 diabetes. In addition, potentially important correlations were demonstrated between psychological factors, neuropathy, body mass index, and physical inactivity.
    Type of Medium: Online Resource
    ISSN: 1099-8004 , 1552-4175
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2006
    detail.hit.zdb_id: 2070503-7
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  • 4
    Online Resource
    Online Resource
    American Diabetes Association ; 2009
    In:  Diabetes Care Vol. 32, No. 9 ( 2009-09-01), p. 1672-1677
    In: Diabetes Care, American Diabetes Association, Vol. 32, No. 9 ( 2009-09-01), p. 1672-1677
    Abstract: Ingestion of a mixed meal recruits flow to muscle capillaries and increases total forearm blood flow in healthy young lean people. We examined whether these vascular responses are blunted by obesity. RESEARCH DESIGN AND METHODS We fed eight middle-aged lean and eight obese overnight-fasted volunteers a liquid mixed meal (480 kcal). Plasma glucose and insulin were measured every 30 min, and brachial artery flow and muscle microvascular recruitment (contrast ultrasound) were assessed every 60 min over 2 h after the meal. RESULTS By 30 min, plasma glucose rose in both the lean (5.1 ± 0.1 vs. 6.7 ± 0.4 mmol/l, P & lt; 0.05) and the obese groups (5.4 ± 0.2 vs. 6.7 ± 0.4 mmol/l, P & lt; 0.05). Plasma insulin rose (28 ± 4 vs. 241 ± 30 pmol/l, P & lt; 0.05) by 30 min in the lean group and remained elevated for 2 h. The obese group had higher fasting plasma insulin levels (65 ± 8 pmol/l, P & lt; 0.001) and a greater postmeal area under the insulin-time curve (P & lt; 0.05). Brachial artery flow was increased at 120 min after the meal in the lean group (38 ± 6 vs. 83 ± 16 ml/min, P & lt; 0.05) but not in the obese group. Muscle microvascular blood volume rose by 120 min in the lean group (14.4 ± 2.2 vs. 24.4 ± 4.2 units, P & lt; 0.05) but not in the obese group. CONCLUSIONS A mixed meal recruits muscle microvasculature in lean subjects, and this effect is blunted by obesity. This impaired vascular recruitment lessens the endothelial surface available and may thereby impair postprandial glucose disposal.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2009
    detail.hit.zdb_id: 1490520-6
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  • 5
    Online Resource
    Online Resource
    SAGE Publications ; 2006
    In:  The Diabetes Educator Vol. 32, No. 6 ( 2006-11), p. 925-939
    In: The Diabetes Educator, SAGE Publications, Vol. 32, No. 6 ( 2006-11), p. 925-939
    Abstract: Purpose The purpose of this descriptive study was to describe attainment of glucose and coronary heart disease (CHD) risk factor goals and to identify factors that were associated with successful goal achievement. Methods A cross-sectional survey enrolled 110 subjects with type 2 diabetes undergoing screening for asymptomatic myocardial ischemia. Results Many participants had HbA1c levels ≥7% (45%), and 46% to 79% were not meeting goals for CHD risk reduction. Individual factors of age, gender, and anxiety; the illness-related factor of lipid-lowering therapy; and the family-related factor of living alone were independently associated with 1 of the 7 outcomes under study. Illness-related factors of a longer duration of diabetes were strongly associated with glucose and blood pressure control, insulin use with glucose control and waist circumference, and antihypertensive use with blood pressure, triglycerides, and body mass index. Family-related factors of higher income were significantly associated with poorer glucose control and higher body mass index, while higher levels of perceived support by family and friends were associated with a lower risk of not meeting lipid goals. However, individual factors, represented by several aspects of personal model beliefs (exercising regularly, testing glucose, and checking one’s feet) and physical activity, were consistently related to lipid and weight control. Conclusions A variety of factors were associated with control of blood glucose and CHD risk factors, suggesting that a one-size-fits-all approach to multiple risk factor reduction efforts may not result in goal attainment.
    Type of Medium: Online Resource
    ISSN: 0145-7217 , 1554-6063
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2006
    detail.hit.zdb_id: 3062380-7
    detail.hit.zdb_id: 2173745-9
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  • 6
    Online Resource
    Online Resource
    Elsevier BV ; 2009
    In:  Journal of the American College of Cardiology Vol. 53, No. 23 ( 2009-06), p. 2175-2183
    In: Journal of the American College of Cardiology, Elsevier BV, Vol. 53, No. 23 ( 2009-06), p. 2175-2183
    Type of Medium: Online Resource
    ISSN: 0735-1097
    RVK:
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2009
    detail.hit.zdb_id: 1468327-1
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