Evidence map›Paper›PMID 19223595›Full record

ArticleDiabetes2009

Medium-chain fatty acids improve cognitive function in intensively treated type 1 diabetic patients and support in vitro synaptic transmission during acute hypoglycemia.

Kathleen A Page, Anne Williamson, Namyi Yu, Ewan C McNay, James Dzuira, Rory J McCrimmon, Robert S Sherwin

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed, 4 pooled it
3.0field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

68 citing papers in PubMed, 4 syntheses or guidelines pooled it, 152 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Trial
  8. Trial
  9. Article
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Review
  19. Article
  20. Article

8 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Kathleen A PageSection of Endocrinology, Yale School of Medicine, New Haven, Connecticut, USA. kathleen.page@yale.edu
Anne Williamson
Namyi Yu
Ewan C McNay
James Dzuira
Rory J McCrimmon
Robert S Sherwin
Yale University · USUniversity at Albany, State University of New York · USWinthrop-University Hospital · US

Funding

YALE UNIVERSITY CLINICAL AND TRANSLATIONAL SCIENCE AWARD PROGRAMUL1RR024139 · NCRR · YALE UNIVERSITY · PI SHERWIN, ROBERT S · 2006 to 2011
$56.8M
GLUCOREGULATORY HORMONE INTERACTIONS IN DIABETESR37DK020495 · NIDDK · YALE UNIVERSITY · PI SHERWIN, ROBERT S · 1995 to 2012
$7.3M
Role of AMPK in hypoglycemia-sensing in the VMHR01DK069831 · NIDDK · YALE UNIVERSITY · PI MCCRIMMON, RORY J · 2004 to 2008
$1.4M
Metabolism and Excitability in Rodent HippocampusR01NS045792 · NINDS · YALE UNIVERSITY · PI WILLIAMSON, ANNE · 2004 to 2006
$788k
NCRR NIH HHS UL1 RR024139NIDDK NIH HHS DK069831NIDDK NIH HHS R01 DK069831NIDDK NIH HHS R37 DK020495NIDDK NIH HHS R37 DK20495NINDS NIH HHS R01 NS045792PHS HHS R01NA045792
6 · The paper itself

Abstract

objectiveWe examined whether ingestion of medium-chain triglycerides could improve cognition during hypoglycemia in subjects with intensively treated type 1 diabetes and assessed potential underlying mechanisms by testing the effect of beta-hydroxybutyrate and octanoate on rat hippocampal synaptic transmission during exposure to low glucose. RESEARCH DESIGN AND

methodsA total of 11 intensively treated type 1 diabetic subjects participated in stepped hyperinsulinemic- (2 mU x kg(-1) x min(-1)) euglycemic- (glucose approximately 5.5 mmol/l) hypoglycemic (glucose approximately 2.8 mmol/l) clamp studies. During two separate sessions, they randomly received either medium-chain triglycerides or placebo drinks and performed a battery of cognitive tests. In vitro rat hippocampal slice preparations were used to assess the ability of beta-hydroxybutyrate and octanoate to support neuronal activity when glucose levels are reduced.

resultsHypoglycemia impaired cognitive performance in tests of verbal memory, digit symbol coding, digit span backwards, and map searching. Ingestion of medium-chain triglycerides reversed these effects. Medium-chain triglycerides also produced higher free fatty acids and beta-hydroxybutyrate levels compared with placebo. However, the increase in catecholamines and symptoms during hypoglycemia was not altered. In hippocampal slices beta-hydroxybutyrate supported synaptic transmission under low-glucose conditions, whereas octanoate could not. Nevertheless, octanoate improved the rate of recovery of synaptic function upon restoration of control glucose concentrations.

conclusionsMedium-chain triglyceride ingestion improves cognition without adversely affecting adrenergic or symptomatic responses to hypoglycemia in intensively treated type 1 diabetic subjects. Medium-chain triglycerides offer the therapeutic advantage of preserving brain function under hypoglycemic conditions without causing deleterious hyperglycemia.

Indexed as

3-Hydroxybutyric AcidAcute DiseaseCognitionCognition DisordersDiabetes Mellitus, Type 1Fatty Acids, NonesterifiedGlucose Clamp TechniqueHumansHypoglycemiaMemorySynaptic TransmissionTriglycerides3-Hydroxybutyric AcidFatty Acids, NonesterifiedTriglycerides

Identifiers

PMID19223595
PMCPMC2671041
OpenAlexW2122541667

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.