@article{aa188372b31e477aa1323e714803f5e7,
title = "Glucose Metabolism and Metabolomic Changes in Response to Prolonged Fasting in Individuals with Obesity, Type 2 Diabetes and Non-Obese People—A Cohort Trial",
abstract = "Metabolic regulation of glucose can be altered by fasting periods. We examined glucose metabolism and metabolomics profiles after 12 h and 36 h fasting in non-obese and obese participants and people with type 2 diabetes using oral glucose tolerance (OGTT) and intravenous glucose tolerance testing (IVGTT). Insulin sensitivity was estimated by established indices and mass spectrometric metabolomics was performed on fasting serum samples. Participants had a mean age of 43 ± 16 years (62% women). Fasting levels of glucose, insulin and C-peptide were significantly lower in all cohorts after 36 h compared to 12 h fasting (p < 0.05). In non-obese participants, glucose levels were significantly higher after 36 h compared to 12 h fasting at 120 min of OGTT (109 ± 31 mg/dL vs. 79 ± 18 mg/dL; p = 0.001) but insulin levels were lower after 36 h of fasting at 30 min of OGTT (41.2 ± 34.1 mU/L after 36 h vs. 56.1 ± 29.7 mU/L; p < 0.05). In contrast, no significant differences were observed in obese participants or people with diabetes. Insulin sensitivity improved in all cohorts after 36 h fasting. In line, metabolomics revealed subtle baseline differences and an attenuated metabolic response to fasting in obese participants and people with diabetes. Our data demonstrate an improved insulin sensitivity after 36 h of fasting with higher glucose variations and reduced early insulin response in non-obese people only.",
keywords = "IVGTT, OGTT, fasting, glucose metabolism, metabolic flexibility, obesity, type 2 diabetes",
author = "Tripolt, {Norbert J.} and Hofer, {Sebastian J.} and Pferschy, {Peter N.} and Faisal Aziz and Sylv{\`e}re Durand and Fanny Aprahamian and Nitharsshini Nirmalathasan and Mara Waltenstorfer and Tobias Eisenberg and Obermayer, {Anna M.A.} and Regina Riedl and Harald Kojzar and Othmar Moser and Caren Sourij and Heiko Bugger and Abderrahim Oulhaj and Pieber, {Thomas R.} and Matthias Zanker and Guido Kroemer and Frank Madeo and Harald Sourij",
note = "Funding Information: H.S. has received funding from the Austrian Science Fund FWF (KLI-851-B). F.M. is grateful to the Austrian Science Fund FWF (F3012, W1226, P29203, P29262, P27893, P31727) and the Austrian Federal Ministry of Education, Science and Research as well as the University of Graz for grants “Unkonventionelle Forschung-InterFast and Fast4Health” and “flysleep” (BMWFW-80.109/0001-WF/V/3b/2015). T.E. acknowledges support from Austrian Science Fund FWF (P 33957 and TAI 602 1000). We acknowledge the support of the Field of Excellence BioHealth of NAWI Graz and the BioTechMed-Graz flagship project “EPIAge”. GK is supported by the Ligue contre le Cancer ({\'e}quipe labellis{\'e}e); Agence National de la Recherche (ANR)—Projets blancs; AMMICa US23/CNRS UMS3655; Association pour la recherche sur le cancer (ARC); Canc{\'e}rop{\^o}le Ile-de-France; European Research Council Advanced Investigator Grand “ICD-Cancer”, Fondation pour la Recherche M{\'e}dicale (FRM); a donation by Elior; Equipex Onco-Pheno-Screen; European Joint Programme on Rare Diseases (EJPRD); European Research Council (ICD-Cancer), European Union Horizon 2020 Projects Oncobiome and Crimson; Fondation Carrefour; Institut National du Cancer (INCa); Institut Universitaire de France; LabEx Immuno-Oncology (ANR-18-IDEX-0001); a Cancer Research ASPIRE Award from the Mark Foundation; the RHU Immunolife; Seerave Foundation; SIRIC Stratified Oncology Cell DNA Repair and Tumor Immune Elimination (SOCRATE); and SIRIC Cancer Research and Personalized Medicine (CARPEM). This study contributes to the IdEx Universit{\'e} de Paris ANR-18-IDEX-0001. Open Access Funding by the Austrian Science Fund (FWF). Publisher Copyright: {\textcopyright} 2023 by the authors.",
year = "2023",
month = feb,
doi = "10.3390/nu15030511",
language = "English",
volume = "15",
journal = "Nutrients",
issn = "2072-6643",
publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",
number = "3",
}