Glutamine and Insulin Sensitivity in Type I Diabetes

Insulin is crucial to help the body metabolize ('burn') sugar (glucose). Even though
juvenile (type 1) diabetes (T1D) is primarily due to the lack of insulin, patients with T1D
tend to become less sensitive to insulin, particularly during adolescence.

The overall objective of this project is to gain further insight into the possible benefits
of supplementation with glutamine (GLN), a natural dietary amino acid, enhancing insulin
sensitivity in adolescents with T1D. To elucidate the impact of glutamine, the
investigators will use a method called the 'euglycemic, hyperinsulinemic clamp': it consists
of giving an IV drip of insulin, while the drop in blood sugar is prevented by giving
variable, precisely measured amounts of glucose by vein: the amount of glucose required to
prevent a drop in blood sugar reflects the body's sensitivity to insulin. The investigators
will also give an IV drip of glucose and arginine (a building block of protein) 'tagged'
with non-radioactive isotopes to better understand how glutamine may work. This procedure
will be performed in 2 groups of 10 adolescents in the morning either after a strenuous
exercise performed the previous afternoon (group 1; n=10), or after a sedentary day (group
2; n=10). Each subject will be studied twice, once after taking oral GLN, once after
placebo, in separate CRC admissions a few weeks apart, in random order.

Should the investigators hypothesis prove to be true, it would warrant long term studies to
determine whether sustained dietary GLN supplementation can decrease insulin requirements
and ultimately improve diabetes control in teenagers with T1DM, If successful, this approach
could potentially have a significant positive impact in terms of adolescent health.