Antecubital Vein Cannula Position Impacts Assessment of Forearm Glucose Uptake During an Oral Glucose Challenge in Healthy Volunteers

Abstract

Introduction Skeletal muscle is a major site for whole-body glucose disposal, and determination of skeletal muscle glucose uptake is an important metabolic measurement, particularly in research focussed on interventions that impact muscle insulin sensitivity. Calculating arterial-venous difference in blood glucose can be used as an indirect measure for assessing glucose uptake. However, the possibility of multiple tissues contributing to the composition of venous blood, and the differential in glucose uptake kinetics between tissue types, suggests that sampling from different vein sites could influence the estimation of glucose uptake. This study aimed to determine the impact of venous cannula position on calculated forearm glucose uptake following an oral glucose challenge in resting and post-exercise states.

Materials and Methods In 9 young, lean, males, the impact of sampling blood from two antecubital vein positions; the perforating vein (‘perforating’ visit) and, at the bifurcation of superficial and perforating veins (‘bifurcation’ visit), was assessed. Brachial artery blood flow and arterialised-venous and venous blood glucose concentrations were measured in 3 physiological states; resting-fasted, resting-fed, and fed following intermittent forearm muscle contraction (fed-exercise).

Results Following glucose ingestion, forearm glucose uptake area under the curve was greater for the ‘perforating’ than for the ‘bifurcation’ visit in the resting-fed (5.92±1.56 vs. 3.69±1.35 mmol/60 min, P<0.01) and fed-exercise (17.38±7.73 vs. 11.40±7.31 mmol/75 min, P<0.05) states.

Discussion Antecubital vein cannula position impacts calculated postprandial forearm glucose uptake. These findings have implications for longitudinal intervention studies where serial determination of forearm glucose uptake is required.

Key words

insulin resistance - skeletal muscle - glucose tolerance test

^* Present address: Department of Diabetology, Pôle DigiDune, Grenoble University Hospital, Grenoble Alpes University, Grenoble, France

Publication History

Received: 22 May 2020
Received: 27 August 2020

Accepted: 30 September 2020

Article published online:
23 October 2020

• References

• 1 De Fronzo RA, Tobin JD, Andres R. Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol 1979; 237: E214-E223
• 2 Matsuda M, DeFronzo RA. Insulin sensitivity indices obtained from oral glucose tolerance testing: Comparison with the euglycemic insulin clamp. Diabetes Care 1999; 22: 1462-1470
• 3 Abdul-Ghani MA, Matsuda M, Balas B. et al. Muscle and liver insulin resistance indexes derived from the oral glucose tolerance test. Diabetes Care 2007; 30: 89-94
• 4 Wilson M, Ross R. Measurement of muscle insulin sensitivity in obese men. Diabetes Metab 2014; 40: 161-164
• 5 Mikines KJ, Richter EA, Dela F. et al. Seven days of bed rest decrease insulin action on glucose uptake in leg and whole body. J Appl Physiol Bethesda Md 1985 1991; 70: 1245-1254
• 6 Jackson RA, Peters N, Advani U. et al. Forearm glucose uptake during the oral glucose tolerance test in normal subjects. Diabetes 1973; 22: 442-458
• 7 Seaquist ER. Comparison of arterialized venous sampling from the hand and foot in the assessment of in vivo glucose metabolism. Metabolism 1997; 46: 1364-1366
• 8 Hoffman RP, Sinkey CA, Dopp JM. et al. Systemic and local adrenergic regulation of muscle glucose utilization during hypoglycemia in healthy subjects. Diabetes 2002; 51: 734-742
• 9 Sonne MP, Højbjerre L, Alibegovic AC. et al. Diminished insulin-mediated forearm blood flow and muscle glucose uptake in young men with low birth weight. J Vasc Res 2010; 47: 139-147
• 10 Forster HV, Dempsey JA, Thomson J. et al. Estimation of arterial PO2, PCO2, pH, and lactate from arterialized venous blood. J Appl Physiol 1972; 32: 134-137
• 11 Liu D, Moberg E, Kollind M. et al. Arterial, arterialized venous, venous and capillary blood glucose measurements in normal man during hyperinsulinaemic euglycaemia and hypoglycaemia. Diabetologia 1992; 35: 287-290
• 12 Gallen IW, Macdonald IA. Effect of two methods of hand heating on body temperature, forearm blood flow, and deep venous oxygen saturation. Am J Physiol 1990; 259: E639-E643
• 13 Hoskins PR. Measurement of arterial blood flow by Doppler ultrasound. Clin Phys Physiol Meas Off J Hosp Phys Assoc Dtsch Ges Med Phys Eur Fed Organ Med Phys 1990; 11: 1-26
• 14 Le Floch JP, Escuyer P, Baudin E. et al. Blood glucose area under the curve. Methodological aspects. Diabetes Care 1990; 13: 172-175
• 15 Honka M-J, Latva-Rasku A, Bucci M. et al. Insulin-stimulated glucose uptake in skeletal muscle, adipose tissue and liver: A positron emission tomography study. Eur J Endocrinol 2018; 178: 523-531
• 16 Murdolo G, Sjöstrand M, Strindberg L. et al. Effects of intrabrachial metacholine infusion on muscle capillary recruitment and forearm glucose uptake during physiological hyperinsulinemia in obese, insulin-resistant individuals. J Clin Endocrinol Metab 2008; 93: 2764-2773
• 17 Møller N, Butler PC, Antsiferov MA. et al. Effects of growth hormone on insulin sensitivity and forearm metabolism in normal man. Diabetologia 1989; 32: 105-110