Modelling the relative contribution of fasting and post-prandial plasma glucose to HbA₁c in healthy and type 2 diabetic subjects

Glycated haemoglobin (HbA₁c) is regarded as the gold standard of glucose homeostasis assessment in diabetes. There has been much discussion in recent medical literature of experimental results concerning the relative contribution of fasting and post-prandial glucose levels to the value of HbA₁c. A mathematical model of haemoglobin glycation is derived and investigated to address this issue

Returns to Human Capital and Investment in New Technology

This paper presents a simple framework that illustrates the link between skill-based wage differentiation and human capital acquisition given skill-biased technical progress. The analysis points to the economic costs resulting from labor market and income redistribution policies that prevent the skill premium from playing its role in fostering human capital accumulation and the adoption of new technologies. The study compares key economic indicators among Canada, France, Germany, the United Kingdom, and the United States. Differences in wage differen-tiation and investment in new technologies among these countries could be related to policies affecting labor markets; such practices may reflect social choices.Human capital;wage, skilled workers, output growth, wages, skilled labor, unskilled workers, income distribution, unskilled labor, worker, wage differentiation, minimum wages, wage differentials, benefits, wage structure, market equilibrium, wage level, fixed investment, earnings distribution, return on capital, labor compensation, compensation, adjustment process, compensation systems, minimum wage, economic cooperation

Chile

This paper presents the primary institutions and economic policies that have led to Chile’s remarkable record of stability and growth over the past twenty years. The core of this policy stance is the combination of fiscal discipline and an open trade policy regime, together with carefully sequenced financial liberalization with in a strengthened regulatory framework.Chile has succeeded in sustaining these policies-despite external and domestic forces to the contrary-because of carefully designed institutional arrangements that encourage policies oriented toward long-term success.Economic growth;central bank, inflation, capital markets, banking, external debt, banking system, external financing, price stability, current account, monetary policy, natural resource, domestic capital, bonds, capital market, government debt, bond, domestic capital markets, inflation targeting, free trade, stock market, export growth, debt sustainability, current account deficit, external position, natural resources, trade liberalization, short-term debt, public debt, hedging, international investment, trade agreements, corporate bonds, nominal interest rate, financial sector, capital inflows, direct investment, long-term debt, equity market, political economy, total external debt, deposit insurance, fdi, balance of payments, debt ratio, monetary fund, bond market, corporate bond market, bond issuance, export prices, debt sustainability analysis, domestic debt, inflation-targeting, independent central bank, financial markets, financial institutions, inflation target, equity markets, portfolio investment, bank credit, trade agreement, output growth, domestic capital market, securities markets, domestic bond, external shocks, corporate bond, mutual funds, external debt sustainability, per capita income, external borrowing, debt dynamics, free trade agreements, net debt, world trade organization, unilateral trade liberalization, domestic currency, world trade, trading partners, exchange rate regime, import substitution, open trade, financial system, currency mismatch, financial liberalization, mortgage bonds, unilateral trade, capital flows, financial market, debt management, liberalization efforts, trade policy strategy, bank policy, world economy, external liquidity, exchange rate target, foreign exchange, trade diversion, debt stock, capital account liberalization, access to capital markets, domestic bond market, bond financing, cost of capital, export orientation, export markets, copper, stock market capitalization, exports of goods, export concentration, investment flows, private debt, budget law, dispute resolution mechanism, multilateral trade, debt service, tariff reductions, trade liberalization process, terms of trade, export sectors, trade liberalization efforts, trade regime, dispute resolution, nontariff barriers, world prices, export sector, debt crisis, reserve bank, investment restrictions, open market, tariff lines, domestic corporate bond, capital gains, bond markets, securities market, access to international capital, monetary authority, foreign currency, capital market reform, capital controls, debt report, international capital markets, prudential regulation, tariff structure, exchange rate regimes, financial assets, indexation, hedging instruments, financial stability, amortization payments, foreign direct investment, export products, foreign banks, banks? assets, lead, international markets, export basket, foreign asset, interest groups, intellectual property, free trade agreement, foreign-owned companies, international financial statistics, bond transactions, capital adequacy, domestic interest rates, local stock market, foreign asset position, access to international capital markets, long-term bonds, bank lending, bank bonds, banking services, holding company, financial instruments, indexed bonds, bank loans, banking law, banking regulation, financial controls, foreign capital, export potential, abundant natural resources, inflationary consequences, merchandise exports, exporters, natural resource endowments, lower inflation, price level, inflation objective, inflation rate, measure of inflation, inflation performance, natural resource abundance, regulatory framework, trade integration, export expansion, export volume, natural resource endowment, reserve assets, money supply, zero tariff, dispute settlement, liberal trade, neighboring countries, high tariffs, intellectual property rights, international standards, open regionalism, economic cooperation, transport costs, exchange rate policies, public finances, balance sheet effect, long-term external debt, reserve holdings, external tariff, domestic investor, external finance, bilateral trade, bilateral agreements, bilateral trade agreements, debt-equity, quantitative restrictions, regional trade, price fluctuations, regional trade agreements, external indebtedness, domestic market, export market, global competitiveness, exchange rate policy, rules of origin, bond issue, foreign capital flows, domestic bond markets, capital market regulation, equity investment, term bonds, hedges, foreign parent companies, foreign assets, capital structure, financial market development, financial regulation, market bond, corporate bond issuance, trade policies, import substitution strategy, export structure, monetary union, domestic financing, endogenous growth, domestic banks, tax incentives, capital market development, financial structure, international capital, export price, tariff reform, government bonds, export base, export behavior, monetary policy objectives, public enterprise debt, export specialization, export goods, export industries, reer, share of exports, export volumes, export patterns, total exports, export growth rates, goods export, export market shares, natural resource sectors, return on equity, interest rate risk, subordinated bonds, financial repression, debt statistics, currency hedging, banking markets, bank licenses, banking sector, bank entry, reserve requirements, banking crises, loan loss provision, savings deposits, bank loan, foreign investment, external debt statistics, foreign asset holdings, foreign parent company, foreign-owned firms, direct investment income, net external liability, debt servicing, foreign liabilities, external liability, portfolio investments, bank ownership, bank origin, derivatives market, mortgage lending, capital adequacy ratio, interbank market, bank ratings, banking market, return on assets, sovereign bonds, sovereign debt, financial contracts, monetary liabilities, asset classification, financial reform, private bank, loan loss reserve, repricing gap, banking community, banking investments, financial services, unstable debt dynamics, bank assets, trade negotiations, tariff reduction, export value, multinational corporations, establishing free trade, trade regimes, reserve accumulation, terms of trade improvement, commercial bank loans, average tariff, uniform tariffs, protectionist measures, rates of protection, domestic companies, domestic growth, protectionist policies, antidumping measures, external credit, quota barriers, trade diversion costs, standard trade theory, external debt financing, free trade areas, import tariffs, trade relations, dispute settlement mechanisms, bilateral treaties, multilateral trade arrangements, regulatory regime, member country, foreign debt, equilibrium model, gross capital formation, endogenous growth theory, debt structure, international trade, trade blocs, economic community, dispute settlement mechanism, guarantee price, preferential tariff, domestic demand, trade areas, domestic financial markets, public debt management, import prices, patent protection, long term debt, export subsidies, abolition of tariffs, bargaining power, perfect competition, multinational firms, external trade, common tariff, balance of payments crises, export earnings, trade policy review, short-term deposits, antidumping actions, trade reforms, agricultural imports, world demand, commodity prices, import-substitution industrialization, multilateral trade negotiations, government bailout, anticompetitive practices, budget balances, liberal trade policy, domestic finance, trade theory, output volatility, unilateral liberalization, unilateral free trade, unilateral tariff reduction, budget laws, outward-oriented countries, international integration, access to debt, low trade, world markets, trade arrangements, positive externalities, debt burden, open trade regimes, domestic investment, political leaders, trade protection, public sector borrowing, exchange rate risk, tariff-free access, venture capital, tariff escalation, exchange rate fluctuations, protection rates, trade deflection, capital ownership, liquidity in bond markets, official reserves, dollar value, reserve requirement, financial intermediation, stock market development, capital restrictions, consumer price index, financial cycles, discounting, moderate inflation, trade policy options, monetary aggregates, rate of inflation, monetary policy frameworks, inflation forecasts, inflation rates, monetary policy decisions, actual inflation, relative prices, capital accumulation, overvaluation, domestic capital market development, hedge, corporate securities, outstanding stocks, capital market reforms, securities firms, outstanding bonds, term bond, market asset, net capital, liquid markets, government securities, stock market liquidity, equity financing, capital market access, external capital, money markets, bond spreads, tariff rate, export incentives, external loan, private sector assets, trade openness, agreement on trade, unemployment rate, floating exchange rate system, foreign ownership, excessive volatility, multilateral negotiations, budget balance, foreign loans, tariff changes, balance sheet effects, trade in services, external debt management, risk diversification, trade sector, preferential access, tariff setting, value of exports, monetary policy implementation, high inflation, monetary stance, steady-state inflation, low inflation, macroeconomic performance, capital injection

Influence of body weight on the performance of glomerular filtration rate estimators in subjects with type 2 diabetes

The American Diabetes Association recommends estimation of glomerular filtration rate (GFR) (1) by either the Cockcroft-Gault (2) or the Modification of Diet in Renal Disease (MDRD) (3) equation in all patients with diabetes. The implication is that these equations provide similar results. Body weight is a numerator in the Cockcroft- Gault equation; however, it is absent from the MDRD equation. This may explain some of the difference in the ability of these equations to estimate GFR in patients with type 2 diabetes, over 80% of whom are obese (4), and may lead to discrepancies in reporting of chronic kidney disease stage (5). Our study was designed to identify whether body weight may explain variability in performance between the Cockcroft-Gault and MDRD equations in patients newly diagnosed with type 2 diabetes

Metabolic implications when employing heavy pre- and post-exercise rapid-acting insulin reductions to prevent hypoglycaemia in Type 1 diabetes patients: a randomised clinical trial

Aim To examine the metabolic, gluco-regulatory-hormonal and inflammatory cytokine responses to large reductions in rapid-acting insulin dose administered prandially before and after intensive running exercise in male type 1 diabetes patients. Methods This was a single centre, randomised, controlled open label study. Following preliminary testing, 8 male patients (24±2 years, HbA1c 7.7±0.4%/61±4 mmol.l−1) treated with insulin's glargine and aspart, or lispro attended the laboratory on two mornings at ∼08:00 h and consumed a standardised breakfast carbohydrate bolus (1 g carbohydrate.kg−1BM; 380±10 kcal) and self-administered a 75% reduced rapid-acting insulin dose 60 minutes before 45 minutes of intensive treadmill running at 73.1±0.9% VO2peak. At 60 minutes post-exercise, patients ingested a meal (1 g carbohydrate.kg−1BM; 660±21 kcal) and administered either a Full or 50% reduced rapid-acting insulin dose. Blood glucose and lactate, serum insulin, cortisol, non-esterified-fatty-acids, β-Hydroxybutyrate, and plasma glucagon, adrenaline, noradrenaline, IL-6, and TNF-α concentrations were measured for 180 minutes post-meal. Results All participants were analysed. All glycaemic, metabolic, hormonal, and cytokine responses were similar between conditions up to 60 minutes following exercise. Following the post-exercise meal, serum insulin concentrations were lower under 50% (p<0.05) resulting in 75% of patients experiencing hyperglycaemia (blood glucose ≥8.0 mmol.l−1; 50% n = 6, Full n = 3). β-Hydroxybutyrate concentrations decreased similarly, such that at 180 minutes post-meal concentrations were lower than rest under Full and 50%. IL-6 and TNF-α concentrations remained similar to fasting levels under 50% but declined under Full. Under 50% IL-6 concentrations were inversely related with serum insulin concentrations (r = −0.484, p = 0.017). Conclusions Heavily reducing rapid-acting insulin dose with a carbohydrate bolus before, and a meal after intensive running exercise may cause hyperglycaemia, but does not augment ketonaemia, raise inflammatory cytokines TNF-α and IL-6 above fasting levels, or cause other adverse metabolic or hormonal disturbances. Trial Registration ClinicalTrials.gov NCT0153185

Counter-regulatory responses to reductions in pre- and post-exercise rapid-acting insulin dose during the experimental trials.

<p>NOTE: Data presented as mean ± SEM. Test meal and insulin were administered immediately following rest and pre-meal sample points.</p><p>* indicates significantly different from Full (<i>p</i>≤0.05).</p>†<p>indicates significantly different from rest.</p>‡<p>indicates significantly different from pre-meal.</p><p>NOTE: Exercise commenced 60 minutes after rest.</p

Metabolic responses to reductions in pre- and post-exercise rapid-acting insulin dose during the experimental trials.

<p>NOTE: Data presented as mean ± SEM. β-OH  =  β-Hydroxybutyrate. Test meal and insulin were administered immediately following rest and pre-meal sample points.</p><p>* indicates significantly different from Full (<i>p</i>≤0.05).</p>†<p>indicates significantly different from rest.</p>‡<p>indicates significantly different from pre-meal.</p><p>NOTE: Exercise commenced 60 minutes after rest.</p

A–B. Time-course changes in IL-6 (A) and TNF-α (B) from rest.

<p>Full  =  black squares, 50%  =  black diamond.* indicates significantly different from Full (<i>p</i><0.05). Transparent sample point within a condition indicates a significant difference from pre-exercise meal concentrations (<i>p</i><0.05). Vertical dashed line break indicates post-exercise intervention. NOTE: test meal and insulin were administered immediately following rest and meal sample points.</p