Novel deuterium metabolic imaging technique reveals distinct patterns of postprandial hepatic glucose homeostasis in individuals with type 1 diabetes and healthy control individuals: a case–control study
Authors' conclusion
By integrating DMI/13C-MRS liver imaging with systemic stable-isotope modelling, this comparative study demonstrates significantly altered hepatic glucose metabolism in adults with well-managed type 1 diabetes vs control individuals, together with substantial phenotypic heterogeneity within the type 1 diabetes cohort. These findings highlight the potential of non-invasive metabolic phenotyping to resolve metabolic alterations and inter-individual variation in type 1 diabetes, which are essential steps towards the provision of precision medicine.
Study context
- Population
- Adults with T1D and healthy control individuals with similar age, BMI and gender distributions
- Participants
- 10 vs 10
- Exposure
- T1D vs healthy controls
- Type 1 diabetesn = 10
- Healthy controlsn = 10reference
- Outcome
- Peak hepatic D-Glc
- Follow-up
- Post-ingestion
Methodological detailscase–control
- Case–control
Main finding
As reported in the abstract
P = 0.02
Observational data: associations, not effects.
Further findings
| Outcome | Healthy controls | P value |
|---|---|---|
| Plasma glucose at baselineT1D vs Healthy controls · higher with T1D | 5.2 ± 0.4 mmol/l | P < 0.001 |
| Glycogen iAUC0-180 in T1D subgroups (hierarchical clustering) · 0–180 minSubgroup 2 vs Subgroup 1 | P = 0.04 |
- Suppression of endogenous glucose production · T1D vs Healthy controls · significantly reduced suppression with T1D
- P = 0.001
- Plasma glucose at baseline: T1D 10.7 ± 2.3 mmol/l
- Glycogen iAUC0-180 in T1D subgroups (hierarchical clustering): Subgroup 2 −3.0 mol/l × min
- Glycogen iAUC0-180 in T1D subgroups (hierarchical clustering): Subgroup 1 2.5 mol/l × min
- Glycogen iAUC0-180 in T1D subgroups (hierarchical clustering): net glycogen depletion in subgroup 2 vs accumulation in subgroup 1
Preprandial glycogen · baseline
- Preprandial glycogen levels did not differ significantly between T1D and controls
Postprandial hepatic glycogen · 150 min
- Clear glycogen increase in control individuals (iAUC0-180)
- 2.4 mol/l × min
- Glycogen did not significantly rise at 150 min in T1D
Postprandial glucagon, systemic insulin exposure and glucose disposal
- Similar systemic insulin exposure, no significant differences in postprandial glucagon, and similar insulin-dependent glucose disposal between groups
Glycogen iAUC0-180 in T1D subgroups (hierarchical clustering) · 0–180 min
- Subgroup 1 had a steeper increase in hepatic and systemic D-Glc profiles; no overt clinical differences between subgroups
Original publication
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