Staub-Traugott Phenomenon

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The Staub-Traugott Phenomenon (or Staub-Traugott Effect) is the premise that a normal subject fed glucose will rapidly return to normal levels of blood glucose after an initial spike, and will see improved reaction to subsequent glucose feedings.[ citation needed ]

Contents

History

A. T. B. Jacobson determined in 1913 that carbohydrate ingestion results in blood glucose fluctuations. [1] Hamman and Hirschman first reported improvement of carbohydrate tolerance following repeated glucose administration in 1919. [2] H. Staub in 1921 and K. Traugott in 1922 subsequently confirmed the improved reaction in healthy subjects and the phenomenon was named for them. [3] [4] As this effect does not occur in diabetic subjects, it became the basis for the Glucose Tolerance Test.[ citation needed ]

Mechanism

Abraira and Lawrence describe the original discovery as being that "when glucose loads are given in succession, orally or intravenously, significant and progressive improvement in glucose tolerance will occur in normal and nonketotic diabetic subjects. This facilitated disposal of a glucose load is known as the Staub-Traugott phenomenon." [5]

This phenomenon drew considerable interest as it was demonstrated that the ingested glucose was still being processed by the gut at the same rate while being cleared much more rapidly in the bloodstream. "It is not surprising that when a large amount of readily diffusible glucose is suddenly introduced into the alimentary tract the rate of absorption should exceed the rate at which the tissues can abstract it from the blood. But it is not so clear why the curve should again fall to normal as rapidly as it often does at a time when the rate of absorption from the gut can be scarcely diminished." [6]

Various mechanisms were hypothesized involving the liver and insulin. It was determined in 2009 that "enhanced potentiation of insulin response and increased suppression of hepatic glucose production are the main mechanisms underlying the Staub-Traugott effect", meaning that the liver slows its release of glucose into the bloodstream and the existing insulin becomes better at clearing glucose from the bloodstream with each dose of glucose administered. [7]

Exceptions and limitations

This effect has been observed to disappear under conditions of starvation and in hypopituitary patients. [5] [8]

Attempts to base dietary and nutrition advice on this effect have met with limited success. [9]

Related Research Articles

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Hypoglycemia, also called low blood sugar, is a fall in blood sugar to levels below normal, typically below 70 mg/dL (3.9 mmol/L). Whipple's triad is used to properly identify hypoglycemic episodes. It is defined as blood glucose below 70 mg/dL (3.9 mmol/L), symptoms associated with hypoglycemia, and resolution of symptoms when blood sugar returns to normal. Hypoglycemia may result in headache, tiredness, clumsiness, trouble talking, confusion, fast heart rate, sweating, shakiness, nervousness, hunger, loss of consciousness, seizures, or death. Symptoms typically come on quickly.

Insulin pump

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The following is a glossary of diabetes which explains terms connected with diabetes.

Glucose tolerance test Medical test of how quickly glucose is cleared from the blood

The glucose tolerance test is a medical test in which glucose is given and blood samples taken afterward to determine how quickly it is cleared from the blood. The test is usually used to test for diabetes, insulin resistance, impaired beta cell function, and sometimes reactive hypoglycemia and acromegaly, or rarer disorders of carbohydrate metabolism. In the most commonly performed version of the test, an oral glucose tolerance test (OGTT), a standard dose of glucose is ingested by mouth and blood levels are checked two hours later. Many variations of the GTT have been devised over the years for various purposes, with different standard doses of glucose, different routes of administration, different intervals and durations of sampling, and various substances measured in addition to blood glucose.

Hyperglycemia Too much blood sugar, usually because of diabetes

Hyperglycemia is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood sugar level higher than 11.1 mmol/l (200 mg/dL), but symptoms may not start to become noticeable until even higher values such as 13.9–16.7 mmol/l (~250–300 mg/dL). A subject with a consistent range between ~5.6 and ~7 mmol/l is considered slightly hyperglycemic, and above 7 mmol/l is generally held to have diabetes. For diabetics, glucose levels that are considered to be too hyperglycemic can vary from person to person, mainly due to the person's renal threshold of glucose and overall glucose tolerance. On average, however, chronic levels above 10–12 mmol/L (180–216 mg/dL) can produce noticeable organ damage over time.

Glycogen Glucose polymer used as energy store in animals

Glycogen is a multibranched polysaccharide of glucose that serves as a form of energy storage in animals, fungi, and bacteria. The polysaccharide structure represents the main storage form of glucose in the body.

Glycemic index Number assigned to food

The glycemic index is a number from 0 to 100 assigned to a food, with pure glucose arbitrarily given the value of 100, which represents the relative rise in the blood glucose level two hours after consuming that food. The GI of a specific food depends primarily on the quantity and type of carbohydrate it contains, but is also affected by the amount of entrapment of the carbohydrate molecules within the food, the fat and protein content of the food, the amount of organic acids in the food, and whether it is cooked and, if so, how it is cooked. GI tables, which list many types of foods and their GIs, are available. A food is considered to have a low GI if it is 55 or less; high GI if 70 or more; and mid-range GI if 56 to 69.

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Reactive hypoglycemia Medical condition

Reactive hypoglycemia, postprandial hypoglycemia, or sugar crash is a term describing recurrent episodes of symptomatic hypoglycemia occurring within four hours after a high carbohydrate meal in people with and without diabetes. The term is not necessarily a diagnosis since it requires an evaluation to determine the cause of the hypoglycemia.

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Isomaltulose Chemical compound

Isomaltulose is a disaccharide carbohydrate composed of glucose and fructose. The glucose and fructose are linked by an alpha-1,6-glycosidic bond. Isomaltulose is present in honey and sugarcane extracts. It tastes similar to sucrose with half the sweetness. Isomaltulose, also known by the trade name Palatinose, is manufactured by enzymatic rearrangement (isomerization) of sucrose from beet sugar. The enzyme and its source were discovered in Germany in 1950, and since then its physiological role and physical properties have been studied extensively. Isomaltulose has been used as an alternative to sugar in foods in Japan since 1985, in the EU since 2005, in the US since 2006, and in Australia and New Zealand since 2007, besides other countries worldwide. Analytical methods for characterization and assay of commercial isomaltulose are laid down, for example, in the Food Chemicals Codex. Its physical properties closely resemble those of sucrose, making it easy to use in existing recipes and processes.

Richard K. Bernstein is a physician and an advocate for a low-carbohydrate diabetes diet to help achieve normal blood sugars for diabetics. Bernstein has type 1 diabetes. His private medical practice in Mamaroneck, New York is devoted solely to treating diabetes and prediabetes. He is a fellow of the American College of Nutrition, the American College of Endocrinology, and The College of Certified Wound Specialists. He is the author of six books on diabetes and normalizing blood sugars.

Blood sugar regulation Hormones regulating blood sugar levels

Blood sugar regulation is the process by which the levels of blood sugar, primarily glucose, are maintained by the body within a narrow range. This tight regulation is referred to as glucose homeostasis. Insulin, which lowers blood sugar, and glucagon, which raises it, are the most well known of the hormones involved, but more recent discoveries of other glucoregulatory hormones have expanded the understanding of this process. The gland called pancreas secrete two hormones and they are primarily responsible to regulate glucose levels in blood.

Chronic Somogyi rebound is a contested explanation of phenomena of elevated blood sugars in the morning. Also called the Somogyi effect and posthypoglycemic hyperglycemia, it is a rebounding high blood sugar that is a response to low blood sugar. When managing the blood glucose level with insulin injections, this effect is counter-intuitive to people who experience high blood sugar in the morning as a result of an overabundance of insulin at night.

Equine metabolic syndrome

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Prediabetes Predisease state of hyperglycemia with high risk for diabetes

Prediabetes is a component of the metabolic syndrome and is characterized by elevated blood sugar levels that fall below the threshold to diagnose diabetes mellitus. It usually does not cause symptoms but people with prediabetes often have obesity, dyslipidemia with high triglycerides and/or low HDL cholesterol, and hypertension. It is also associated with increased risk for cardiovascular disease (CVD). Prediabetes is more accurately considered an early stage of diabetes as health complications associated with type 2 diabetes often occur before the diagnosis of diabetes.

MODY 2 is a form of maturity onset diabetes of the young.

Sleep is important in regulating metabolism. Mammalian sleep can be sub-divided into two distinct phases - REM and non-REM (NREM) sleep. In humans and cats, NREM sleep has four stages, where the third and fourth stages are considered slow-wave sleep (SWS). SWS is considered deep sleep, when metabolism is least active.

References

  1. ↑ "Jacobsen ATB. Untersuchungen uber den Einfluss verschiedener Nahrungsmittel auf den Blutzucker bei normalen, zuckerkranken und graviden Personen. Biochem Z 1913;56:471–494".{{cite journal}}: Cite journal requires |journal= (help)
  2. ↑ "Hamman L, Hirschman II. Studies on blood sugar. Effects upon the blood sugar of the repeated ingestion of glucose. Johns Hopkins Hospital Bulletin 344: 306–308, 1919".{{cite journal}}: Cite journal requires |journal= (help)
  3. ↑ "Traugott über das Verhalten des Blutzucher. Spiegels bei Wiederholter und verschiedener Art enteraler Zuckerzufuhr und dessen Bedeutung für die Leberfunktion. Klin Woch 1 i: 892–894, 1922".{{cite journal}}: Cite journal requires |journal= (help)
  4. ↑ "Staub H. Untersuchungen über den Zuckerstoffwechsel des Menschen. I Mitteilung Z Klin Med 91: 44–60, 1921".{{cite journal}}: Cite journal requires |journal= (help)
  5. 1 2 "C. Abraira and A. M. Lawrence, The Staub-Traugott phenomenon III. Effects of starvation, Am. I. Clin. Nutr. 31: 213-221, 1978".{{cite journal}}: Cite journal requires |journal= (help)
  6. ↑ "G. L. Foster, Studies on carbohydrate metabolism: II. An interpretation of the blood sugar phenomena following the ingestion of glucose, J. Biol. Chem. 1923, 55:303-314".{{cite journal}}: Cite journal requires |journal= (help)
  7. ↑ "Bonuccelli S et al, Improved tolerance to sequential glucose loading (Staub-Traugott effect): size and mechanisms, Am J Physiol Endocrinol Metab. 2009 Aug;297(2):E532-7".{{cite journal}}: Cite journal requires |journal= (help)
  8. ↑ "Abraira, C., Graham, L. A., & Lawrence, A. M. (1975). Absence of facilitated glucose disposal (Staub-Traugott effect) in subjects with hypopituitarism. Metabolism, 24(10), 1145-1155".{{cite journal}}: Cite journal requires |journal= (help)
  9. ↑ "Jenkins, D. J., Alexandra L. Jenkins, T. M. Wolever, Vladimir Vuksan, A. Venket Rao, Lilian U. Thompson, and Robert G. Josse. "Low glycemic index: lente carbohydrates and physiological effects of altered food frequency." The American journal of clinical nutrition 59, no. 3 (1994): 706S-709S".{{cite journal}}: Cite journal requires |journal= (help)
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