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  • 1
    ISSN: 1432-0428
    Keywords: Keywords Gestational diabetes ; glucose metabolism ; insulin secretion ; intravenous glucose tolerance test ; minimal model ; pregnancy ; stable isotope.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Gestational diabetes affects 2–3 % of pregnant women and is associated with foetal complications including macrosomia and an increased likelihood of developing diabetes in later life. We have therefore studied seven women with gestational diabetes and five control women both during the third trimester of pregnancy and again 2–3 months post-partum, using the minimal model analysis of the frequently sampled labelled ([6, 6-2H2]-glucose) intravenous glucose tolerance test. Glucose tolerance (glucose Kd) was significantly reduced in the women with gestational diabetes compared with the normal pregnant women both in pregnancy (1.16 ± 0.11 vs 1.78 ± 0.23 %/min; p 〈 0.05) and post-partum (1.47 ± 0.22 vs 2.59 ± 0.43 %/min; p 〈 0.05) and increased significantly in the control women after delivery (p 〈 0.05). Glucose effectiveness was not significantly different between the women with gestational diabetes and the control group either during or after pregnancy. Insulin sensitivity was significantly lower during pregnancy than after delivery in the women with gestational diabetes (p 〈 0.05). There was no significant difference in basal insulin secretion in the two groups during pregnancy or post-partum. However, during pregnancy the control subjects significantly increased (p 〈 0.001) their insulin secretion over a period of 20 min in response to an intravenous glucose tolerance test (96.2 ± 42.7 pmol/kg) compared with post-partum values (58.3 ± 25.2 pmol/kg) while in the women with gestational diabetes insulin secretion was similar in pregnancy (65.5 ± 9.3 pmol/kg) and after delivery (57.7 ± 15.7 pmol/kg). These data suggest that the glucose intolerance in gestational diabetes compared to normal pregnancy is due to reduced insulin sensitivity and an impaired ability in gestational diabetes to increase insulin secretion in response to glucose. [Diabetologia (1996) 39: 976–983]
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; insulin-dependent ; glucose recycling ; glucose ; insulin ; Cori cycle ; isotopes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Six Type 1 (insulin-dependent) diabetic subjects were studied in order to determine the contribution of recycling of glucose carbon to the overproduction of glucose which is characteristic of the fasting hyperglycaemia produced by insulin withdrawal. The subjects were studied on two occasions, once after an overnight insulin infusion and once following 24 h of insulin withdrawal. The difference in turnover rates of 1-14C-glucose and 3-3H-glucose was used as a measure of glucose recycling. Insulin withdrawal caused a marked metabolic derangement with a rise in non-esterified fatty acids from 0.69±0.23 to 1.11±0.21 mmol/l (mean±SEM, p〈0.05), total ketones from 0.27±0.06 to 2.06±0.51 mmol/l (p〈0.01), cortisol from 341±43 to 479±31 nmol/l (p〈0.05) and growth hormone from 1.1±0.3 to 19+5-mu/l (p〈0.05). Glucose turnover rose from 13.8±2.3 μmol·kg−1·min−1 at a glucose of 6.9±0.7 mmol/l in the insulin infused study to 25.8±4.4 μmol·kg−1·min−1 (p〈0.05) at a glucose of 16.4±0.7 mmol/l in the insulin withdrawn study. Recycling also rose from 3.0±0.4 μmol· kg−1·min−1 to 9.4±2.2 μmol·kg−1·min−1 (p〈0.05) when insulin withdrawn, accounting for 23±3% and 36±3% of glucose turnover, respectively. We conclude that in the severely insulin deficient Type 1 diabetic subject recycling of glucose carbon is a major contributor to the excess glucose production.
    Type of Medium: Electronic Resource
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