- Alpha-Lipoic acid treatment decreases
serum lactate and pyruvate concentrations and improves glucose
effectiveness in lean and obese patients with type 2 diabetes.
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- Konrad T; Vicini P; Kusterer K; Hšoflich
A; Assadkhani A; Bšohles HJ; Sewell A; Tritschler HJ; Cobelli C;
Usadel KH
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- Department of Internal Medicine, J.W.
Goethe-University, Frankfurt, Germany.
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- Diabetes Care, 22(2):280-7 1999 Feb
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- Abstract:
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- OBJECTIVE:
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- We examined the effect of lipoic acid
(LA), a cofactor of the pyruvate dehydrogenase complex (PDH), on
insulin sensitivity (SI) and glucose effectiveness (SG) and on serum
lactate and pyruvate levels after oral glucose tolerance tests (OGTTs)
and modified frequently sampled intravenous glucose tolerance tests (FSIGTTs)
in lean (n = 10) and obese (n = 10) patients with type 2 diabetes.
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- RESEARCH DESIGN AND METHODS:
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- FSIGTT data were analyzed by minimal
modeling technique to determine SI and SG before and after oral
treatment (600 mg, twice a day, for 4 weeks). Serum lactate and
pyruvate levels of diabetic patients after glucose loading were
compared with those of lean (n = 10) and obese (n = 10) healthy
control subjects in which SI and SG were also determined from FSIGTT
data.
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- RESULTS:
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- Fasting lactate and pyruvate levels were
significantly increased in patients with type 2 diabetes. These
metabolites did not exceed elevated fasting concentrations after
glucose loading in lean patients with type 2 diabetes. However, a
twofold increase of lactate and pyruvate levels was measured in obese
diabetic patients. LA treatment was associated with increased SG in
both diabetic groups (lean 1.28 +/- 0.14 to 1.93 +/- 0.13; obese 1.07
+/- 0.11 to 1.53 +/- 0.08 x 10(-2) min-1, P < 0.05). Higher SI and
lower fasting glucose were measured in lean diabetic patients only (P
< 0.05). Lactate and pyruvate before and after glucose loading were
approximately 45% lower in lean and obese diabetic patients after LA
treatment.
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- CONCLUSIONS:
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- Treatment of lean and obese diabetic
patients with LA prevents hyperglycemia-induced increments of serum
lactate and pyruvate levels and increases SG.
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