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  • 1
    ISSN: 1432-0428
    Keywords: Acute insulin response ; Type 1 (insulin-dependent) diabetes mellitus ; risk ; glucose ; glucagon ; arginine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The relationships between first-phase insulin secretion to i.v. glucagon and i.v. arginine were studied in 19 healthy adult volunteers (Group I) and in 21 subjects at risk for Type 1 (insulin-dependent) diabetes mellitus with either a “normal” (n=11; Group II a) or a “low” insulin response to i.v. glucose (n=10; Group II b). Groups I and II a displayed similar insulin responses to the three secretagogues. In contrast, Group II b demonstrated lower insulin responses to both glucagon and arginine than control subjects (p}〈0.007 and (p}〈0.04 respectively) orthan “normo-responders” to glucose (#x007D;〈0.007 and p〈0.04 respectively). In Group II b however, arginine-stimulated insulin release was increased compared to the response to glucose (p}〈0.006), while glucagon and glucose led to non-statistically different responses. Five “low-responders” developed Type 1 diabetes. As a group, they displayed lower responses to glucagon and to arginine than subjects who up to now have not developed the disease (p〈0.05 and p〈0.0003 respectively). In the subjects who progressed to diabetes, the responses to glucose and glucagon were similarly blunted. In the “low-responders” who have not developed the disease, no statistical difference could be detected between mean responses to glucagon and glucose, but four out of these five subjects had a glucagon-stimulated response within the control range and higher than their corresponding response to glucose. Arginine led to a higher stimulation than glucose, in subgroups that either progressed to diabetes (p〈0.006) or did not (p〈0.002). Finally, “low-responders” who did not develop diabetes displayed similar responses to both glucagon and arginine than “normo-responders” to glucose. A progressive decrease of arginine-stimulated insulin response may be a later event during pre-Type 1 diabetes than a blunted response to glucose, while a loss of glucagon-stimulated insulin release may be intermediate. Diminished response to all secretagogues may offer better prediction than a “low” response to glucose alone.
    Type of Medium: Electronic Resource
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