Ananda Basu, M.D., and researchers recently studied the difference in post-prandial glucose turnover between adolescents and adults with Type 1 diabetes (T1D).
Basu and colleagues’ research resulted in the research article “Postprandial Glucose Turnover Differs Between Adolescents and Adults With Type 1 Diabetes: Triple Tracer Mixed Meal Study,” which was published in the world’s leading peer-reviewed journal on endocrinology, diabetes, and metabolism: The Journal of Clinical Endocrinology and Metabolism (JCEM).
Basu is a professor in the UAB Division of Endocrinology, Diabetes, and Metabolism and senior scientist in the UAB Comprehensive Diabetes Center (UCDC). He is the author of nearly 200 peer-reviewed publications in the fields of medicine, physiology, diabetes care and clinical endocrinology and metabolism.
Post-prandial excursions, or glucose levels post-meal, and insulin sensitivity (SI) are two challenges to maintaining ideal blood glucose with T1D.
Specifically, the researchers’ objective was to compare post-prandial glucose turnover and SI between adolescents and adults with T1D and determine if SI varies with age.
Basu and researchers conducted a clinical study of 21 early adolescents (age 11-13 yrs.) with T1D (T1D-adol), 13 adults with T1D (T1D-adult) and 14 adults without T1D (ND). Using triple tracer mixed meal and oral glucose models, SI in T1D adolescents and adults was compared.
Researchers found that among T1D-adol and T1D-adult, post-prandial glucose excursions were not different, but post-prandial glucagon excursions were significantly lower in T1D-adol when compared to T1D-adult. SI was higher in T1D-adolescent and ND compared to T1D-adult. While meal glucose appearance did not differ between groups, T1D-adol demonstrated greater suppression of post-prandial endogenous glucose production implying that better hepatic insulin sensitivity, possibly due to lower glucagon levels in T1D-adol, was the primary driver of better SI in T1D-adol vs. T1D-adults.
The study results indicate a possibility that over time with T1D endogenous glucose production increases and SI deteriorates, further supporting the theory that SI varies with age in T1D: “We found that adolescents with T1D at age 11 to 12 had higher insulin sensitivity than adults with T1D, supporting gradual increases in T1D-related insulin resistance over time. It is possible that as the duration of T1D increases glucagon secretion increases contributing to worsening SI due to worsening hepatic insulin resistance. We are following the T1D-adol annually to determine the time course of changes in all the above parameters through puberty.”