Recent research suggests that amino acids can significantly increase skeletal muscle glucose uptake. However, the mechanism(s) have not been fully elucidated and it is also not clear if the beneficial impact amino acids have on healthy tissue translates to insulin resistant skeletal muscle. Therefore, in this series of studies, the effects of an amino acid mixture on glucose tolerance and insulin resistance were investigated. Study 1 Experiment-1 (Exp-1) demonstrated that an amino acid mixture significantly reduced the blood glucose response to an oral glucose challenge in Sprague Dawley rats. In Study 1 Exp-2, it was found that the improved glucose tolerance was due to an increase in skeletal muscle glucose uptake. The enhanced amino acid induced muscle glucose uptake was associated with improved cellular signaling. In Study 1 we could not determine the combined and/or individual effects of insulin and amino acids on glucose uptake, so in Study 2, the hindlimb of Sprague Dawley rats were perfused with glucose with or without amino acids in the presence and absence of insulin. Study 2, confirmed our previous findings that an amino acid mixture increased skeletal muscle glucose uptake compared to a carbohydrate supplement in the presence of insulin. The enhanced amino acid-stimulated glucose uptake was not due to increased phosphatidylinositol 3-kinase (PI 3-kinase) activity, although it was related to an increase in Akt substrate of 160 kDa (AS160) phosphorylation and a greater number of glucose transporters at the plasma membrane. In the final experiment, Study 3 investigated whether amino acids could improve glucose tolerance in an insulin resistant model. Study 3 Exp-1, demonstrated that an amino acid mixture significantly lowered the blood glucose response to an oral glucose challenge in obese Zucker rats. Study 3 Exp-2 showed that the improved glucose tolerance was due to enhanced amino acid induced skeletal muscle glucose uptake. Taken together, the results of this research suggests that adding an amino acid mixture to a carbohydrate supplement improves the blood glucose response to an oral glucose challenge, acutely lowers insulin resistance and this appears due to increased skeletal muscle glucose clearance and enhanced cellular signaling. / text

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This study aimed to examine potential mechanisms for glucocorticoid (GC)-induced decreases in glucose clearance, and to determine if a reduction in oxidative stress load via dietary pre-treatment with an antioxidant-rich diet has a positive net effect on glucose tolerance following a sub-chronic treatment with the GC analogue dexamethasone (DEX). Rats fed a diet supplemented with 700IU of -tocopherol for two weeks had improved glucose clearance after five days of DEX-treatment relative to unsupplemented rats as well as decreased markers of oxidative stress. Following an intraperitoneal bolus of insulin, phosphorylation of AMP activated protein kinase (AMPK) was preserved in the supplemented groups despite no significant differences in upstream insulin signalling cascade intermediates between DEX-treated groups. This was corroborated by a similar increase (p<0.05) in phosphorylation of the downstream AMPK substrate acetyl CoA carboxylase. This study demonstrated that -tocopherol supplementation can attenuate GC-induced decreases in glucose clearance in an AMPK-dependent manner. / Nutrition and Metabolism

Background Surgery induces insulin resistance that might be alleviated by a nutritional drink given preoperatively. The authors hypothesized that some of the beneficial effects of the drink could be attributed to the volume component (approximately 1 L) rather than to the nutrients. Methods Sixty patients scheduled for elective total hip replacement under spinal anesthesia were recruited to a clinical trial, and randomly allocated to preoperative fasting, to oral ingestion of tap water, or to oral ingestion of a carbohydrate drink. An intravenous glucose tolerance test calculated glucose clearance and insulin sensitivity on the day before surgery, in the postoperative ward, and on the day after surgery. Other parameters were stress (cortisol in plasma and urine), muscle catabolism (urinary 3-methylhistidine), and wellbeing. Results Fifty-seven patients completed the study. In the postoperative ward, the glucose clearance and the insulin response had decreased from the previous day by 23% and 36%, respectively. Insulin sensitivity did not decrease until the next morning (−48%) and was due to an increased insulin response (+51%). Cortisol excretion was highest on the day of surgery, while 3-methylhistidine increased 1 day later. Follow-up on the third postoperative day showed an average of 1.5 complications per patient. Wellbeing was better 2 weeks after than before the surgery. None of the measured parameters differed significantly between the study groups. Conclusions Preoperative ingestion of tap water or a nutritional drink had no statistically significant effect on glucose clearance, insulin sensitivity, postoperative complications, or wellbeing in patients undergoing elective hip surgery. / <p>Funding Agencies|Olle Engkvist Byggmastare Foundation||Stockholm County Council|2009-0433|</p>