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  • 1
    Electronic Resource
    Electronic Resource
    Insulin production rate, hepatic insulin retention and splanchnic carbohydrate metabolism after oral glucose ingestion in hyperinsulinaemic Type 2 (non-insulin-dependent) diabetes mellitus (1982)
    Springer
    Diabetologia 23 (1982), S. 6-15 
    Details
    ISSN: 1432-0428
    Keywords: Obesity ; Type 2 diabetes ; hyperinsulinaemia ; insulin production rate ; splanchnic insulin retention ; splanchnic glucose output ; insulin resistance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To differentiate peripheral and hepatic insulin resistance in hyperinsulinaemic overweight Type 2 (non-insulin-dependent) diabetic patients (n = 17; 143±4% ideal body weight; mean±SEM) arterial concentrations and splanchnic exchange of glucose, pyruvate, lactate, non-esterified fatty acids, β-hydroxybutyrate and acetoacetate, as well as the insulin production rate, were determined before and during oral glucose loads of 25 g or 100 g. Insulin production rate, hepatic insulin retention and splanchnic exchange of glucose and metabolites were estimated by means of the hepatic venous catheter technique. In the basal state insulin production rate was greater in overweight Type 2 diabetic patients (2.57±0.28 pmol.kg-1. min-1) than in healthy control subjects (1.68±0.17 pmol.kg-1. min-1; p〈0.01). After ingestion of 25 g glucose, the cumulative insulin production rate exceeded normal values (p 〈 0.05), but was below normal with 100 g glucose (p 〈 0.01). Relative insulin trapping by the splanchnic bed in the diabetic patients was 54±3%, not different from normal. Following a 100 g glucose load, splanchnic insulin retention fell by 20% in the patients, and less consistently so in healthy controls. Splanchnic glucose output was normal in the diabetic patients both in the basal state and after glucose ingestion although the induced arterial blood glucose levels were greater in the diabetic patients than in control subjects (p 〈 0.005). Splanchnic output of pyruvate (p 〈 0.025), lactate (p 〈 0.01), and β-hydroxybutyrate (p 〈 0.005) were greater in the basal state in the diabetic patients than in healthy subjects. However, no difference in splanchnic exchange was seen between the two groups in their metabolites' respective response to glucose ingestion. These data suggest that obese hyperinsulinaemic Type 2 diabetic patients may represent a subgroup of diabetic patients with predominantly peripheral, but compensated hepatic, insulin resistance being associated with an increased basal insulin production rate which only exhausts after ingestion of a large glucose load.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00257722
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Acetyl-salicylic acid impairs insulin-mediated glucose utilization and reduces insulin clearance in healthy and non-insulin-dependent diabetic man (1985)
    Springer
    Diabetologia 28 (1985), S. 671-676 
    Details
    ISSN: 1432-0428
    Keywords: Acetyl-salicylic acid ; indomethacin ; glucose utilization ; insulin sensitivity ; insulin secretion ; insulin clearance ; hepatic glucose production ; Type 2 diabetes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of acetyl-salicylic acid (ASA, 3 g per day for 3 days) on glucose utilization and insulin secretion was studied in healthy volunteers and Type 2 diabetic patients using the hyperglycaemic and euglycaemic insulin clamp technique. When in healthy subjects arterial plasma glucose was acutely raised and maintained at +7 mmol/l above fasting level, the plasma insulin response was enhanced by ASA (70±7 vs. 52±7mU/l), whereas the plasma C-peptide response was identical. Despite higher insulin concentrations, glucose utilization was not significantly altered (control, 61±7; ASA, 65±6μmol·kg−1·min−1) indicating impairment of tissue sensitivity to insulin by ASA. Inhibition of prostaglandin synthesis was not likely to be involved in the effect of ASA, since insulin response and glucose utilization were unchanged following treatment with indomethacin. In the euglycaemic insulin (1 mU·kg−1·min−1) clamp studies, glucose utilization was unaltered by ASA despite higher insulin concentrations achieved during constant insulin infusion (103±4vs. 89±4mU/l). In Type 2 diabetic patients, fasting hyperglycaemia (10.6 ±1.1 mmol/l) and hepatic glucose production (15±2 μmol·kg−1·min−1) fell upon ASA treatment (8.6±0.7 mmol/l; 13±1 μmol·kg−1· min−1). During the hyperglycaemic clamp study, the plasma response of insulin, but not of C-peptide, was enhanced by ASA, whereas tissue sensitivity to insulin was reduced by 30 percent. It is concluded that in healthy and Type 2 diabetic man, ASA impairs tissue sensitivity to the action of insulin. This effect is counterbalanced by an augmented plasma insulin response to glucose, which results from a reduced insulin clearance rate. In Type 2 diabetic patients, the reduction in hepatic glucose production may be responsible for the amelioration of hyperglycaemia following ASA treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00291974
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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