ORCID Profile
0000-0003-1526-5311
Current Organisation
Healthier You Pty Ltd
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Publisher: Portland Press Ltd.
Date: 10-1993
DOI: 10.1042/BJ2950287
Abstract: Our aim was to study glucose transporters GLUT1 and GLUT4 in relation to in vivo glucose uptake in rat cardiac and skeletal muscle. The levels of both transporters were of a similar order of magnitude in whole muscle tissue (GLUT1/GLUT4 ratio varied from 0.1 to 0.6), suggesting that both may have an important physiological role in regulating muscle glucose metabolism. GLUT4 correlated very strongly (r2 = 0.97) with maximal insulin-stimulated glucose uptake (Rg' max., estimated using the glucose cl plus 2-deoxy[3H]glucose bolus technique) in six skeletal muscles and heart. A distinct difference in regulation of the two transporters was evident in heart: in 5 h-fasted rats, basal glucose uptake and GLUT1 levels in heart were very high and both were reduced, by 90 and 60% respectively, by 48 h fasting. However, in heart (and in red skeletal muscle), neither GLUT4 levels nor Rg' max. were reduced by 48 h fasting. GLUT1 was shown to be specifically expressed in cardiac myocytes, because intracellular vesicles enriched in GLUT4 contained significant levels of GLUT1. In conclusion, the high association of muscle GLUT4 content with insulin responsiveness in different muscles, and the preservation of both with fasting, supports a predominant role of GLUT4 in insulin-mediated glucose uptake. GLUT1 may play an important role in mediating cardiac muscle glucose uptake in the basal metabolic state. Marked changes in GLUT1 expression with alterations in the metabolic state, such as prolonged fasting, may play an important role in cardiac glucose metabolism.
Publisher: American Diabetes Association
Date: 02-1991
Abstract: Both exercise training and dietary manipulation (increasing ω-3/ω-6 fat ratio) can ameliorate insulin resistance caused by a high-fat diet in rats. We determined whether alterations in the expression of the insulin-regulatable (IR) and/or HepG2 glucose-transporter (GT) mRNAs were similarly affected. There was a significantly higher level of IRGT mRNA in skeletal muscle from exercise-trained versus sedentary high-fat–fed rats (27% increase, P & 0.01). This difference is consistent with previously reported increases in muscle insulin-mediated glucose uptake. Skeletal muscle HepG2GT mRNA was too low to detect any training effect, but there was a tendency toward higher levels with training in cardiac muscle. In contrast, dietary manipulation, previously shown to lead to a much greater increase (100–300%) in muscle insulin-mediated glucose uptake, did not change IRGT or HepG2GT mRNA in skeletal muscle or heart. Thus, both dietary manipulation and exercise training increase insulin-stimulated glucose uptake in skeletal muscle, but only exercise training increases IRGT mRNA. Therefore, exercise training apparently increases GT production, whereas dietary manipulation improves glucose transport in skeletal muscle by other mechanisms.
Publisher: American Physiological Society
Date: 04-1990
DOI: 10.1152/AJPENDO.1990.258.4.E701
Abstract: Recent reports conflict on the effect that pentobarbital anesthesia has on basal glucose turnover in the rat. It is also unclear whether pentobarbital alters insulin suppressibility of hepatic glucose production (Ra). We examined these issues by performing basal and hyperinsulinemic euglycemic cl studies in anesthetized and conscious animals. Ra and glucose utilization (Rd) were estimated using a steady-state infusion of 3-[3H]glucose. Pentobarbital anesthesia in normothermic rats transiently elevated plasma glucose but resulted in a sustained suppression of basal Ra (10.4 +/- 0.3 vs. conscious 13.2 +/- 0.9 mg.kg-1.min-1, P less than 0.05). In the insulin-stimulated state (110 mU/l), despite similar plasma glucose and insulin levels, cl glucose infusion rate was significantly reduced in anesthetized animals (11.1 +/- 0.9 vs. conscious 23.6 +/- 1.3 mg.kg-1.min-1, P less than 0.001). This can be attributed to both a significantly lower insulin-stimulated Rd (15.4 +/- 1.3 vs. conscious 22.8 +/- 1.4 mg.kg-1.min-1, P less than 0.005) and reduced insulin suppression of Ra (4.3 +/- 0.8 vs. conscious -0.8 +/- 0.5 mg.kg-1.min-1, P less than 0.001 i.e., anesthetized 59% vs. conscious 100% reduction of basal Ra). Thus pentobarbital anesthesia significantly reduces basal Ra and induces hepatic insulin resistance (reduces Ra suppressibility). Pentobarbital effects are not dependent on induced hypothermia, but this exacerbates the metabolic perturbation. Caution should be used in extrapolating from the anesthetized to the conscious state.
Publisher: Wiley
Date: 04-10-2022
DOI: 10.1111/JHN.12950
Abstract: Dietitians working in private practices in primary settings provide nutrition care to support in iduals with the prevention and management of chronic disease. A better understanding of the type and usage of data collected by dietitians in this setting may provide insights to optimise the effectiveness and impact of the workforce. The present study explored the perceptions of leading Australian private practice dietitians on the collection and usage of data in their practice. A qualitative descriptive study of Australian private practice dietitians, recruited by snowball s ling, was conducted on their perceptions and attitudes towards collecting and using data. Data were collected by semi‐structured interviews and all interview data were thematically analysed. Twenty‐three dietitians participated. Five themes emerged: (i) collecting data is challenging, nuanced, unclearly defined and therefore not routinely carried out (ii) consistent data collection processes are impeded by the ersity of practise and practices (iii) business‐related data collection is essential for sustainable dietetic services (iv) clinical outcomes are fundamental to dietetic services and (v) standardised, integrated systems are needed to enable routine data collection and synthesis. Our findings demonstrate the rudimentary role business acumen has in practice viability and provides evidence to potentially re‐shape the future of dietetic education in Australia. Private practice dietitians may benefit from tools and training that enable consistent collection of data about their services. Such data could enable benchmarking across the workforce and contribute to a broader understanding of dietetic impact on public health.
Publisher: Center for Open Science
Date: 27-07-2021
Abstract: This is a preprint provide to the AIHW. This publication is currently under review by the Journal of Human Nutrition and Dietetics.
Publisher: Wiley
Date: 23-08-2023
Abstract: To assess the feasibility of implementing data standards in Australian primary care dietetics practices. A mixed‐methods pragmatic study of dietitians working in primary care. Using a four‐point Likert scale, participants were surveyed on their baseline use of the 45 business and 33 clinical evidenced‐based data standards. The content validity index and kappa statistic for each standard were calculated with a kappa statistic of 0.60–0.74 considered ‘Good’ and 0.74 ‘Excellent’. After 4 weeks of assessment, dietitians were surveyed on the feasibility of implementing each standard and standards in total. Qualitative feedback on enablers and barriers to implementing standards was gathered and triangulated with interviews with select participants. Forty‐five dietitians from every Australian state and territory completed both surveys (response rate: 100%). At baseline, 24% of business and 79% of clinical standards were rated ‘Good’ or ‘Excellent’ for current usage. The feasibility of implementing standards was rated ‘Good’ or ‘Excellent for 86% of the business and 97% of the clinical standards. Software, training and time limitations are enablers and barriers to implementing standards. Embedding data standards within dietetics practices are feasible and have broad applicability for assessing outcomes of care.
Publisher: Wiley
Date: 10-10-2022
Abstract: To identify minimum reporting standards for assessing the processes and outcomes of Australian primary care dietetics practice. A sequential, mixed‐method, exploratory process with peer‐nominated Australian ‘thought leaders’. A literature review was undertaken to identify possible standards, followed by semi‐structured qualitative interviews with thought leaders. Content analysis was used to identify a comprehensive group of items that could inform evidence‐based reporting standards. Two rounds of a modified Delphi survey were conducted with the same thought leaders to seek consensus on the most relevant items. In idual items were analysed for content validity, and those with a rating of excellent item‐content validity (index .78) were included as evidenced‐based standards for primary care practice. Twenty‐six thought leaders (response rate: 87%) from all mainland Australian states completed a qualitative interview and two rounds of modified‐Delphi consensus surveys. Items were identified and categorised into three domains: business, clinical, and implementation. Content analysis identified 216 items published or used in practice by the thought leaders. After two rounds of consensus review, 97 items (45 business, 33 clinical, and 19 implementation) achieved excellent consensus ratings. Combining these items into a standardised tool, the scale‐content validity index average was .90, which is considered excellent content validity. This study has identified minimum reporting standards for evidence‐based process and outcome assessments in primary care dietetics practice in Australia. Incorporating such standards into a standardised tool could enable benchmarking across the dietetics workforce and contribute to a broader understanding of the dietetic impact on public health.
Location: Australia
Location: United States of America
No related grants have been discovered for Peter Clark.