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  • 1
    Electronic Resource
    Electronic Resource
    Estimates of Krebs cycle activity and contributions of gluconeogenesis to hepatic glucose production in fasting healthy subjects and IDDM patients (1995)
    Springer
    Diabetologia 38 (1995), S. 831-838 
    Details
    ISSN: 1432-0428
    Keywords: Key words Gluconeogenesis ; Krebs cycle ; fasting ; insulin-dependent diabetes mellitus ; liver.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Normal subjects, fasted 60 h, and patients with insulin-dependent diabetes mellitus (IDDM), withdrawn from insulin and fasted overnight, were given phenylacetate orally and intravenously infused with [3-14C]lactate and 13C-bicarbonate. Rates of hepatic gluconeogenesis relative to Krebs cycle rates were estimated from the 14C distribution in glutamate from urinary phenylacetylglutamine. Assuming the 13C enrichment of breath CO2 was that of the CO2 fixed by pyruvate, the enrichment to be expected in blood glucose, if all hepatic glucose production had been by gluconeogenesis, was then estimated. That estimate was compared with the actual enrichment in blood glucose, yielding the fraction of glucose production due to gluconeogenesis. Relative rates were similar in the 60-h fasted healthy subjects and the diabetic patients. Conversion of oxaloacetate to phosphoenolpyruvate was two to eight times Krebs cycle flux and decarboxylation of pyruvate to acetyl-CoA, oxidized in the cycle, was less than one-30th the fixation by pyruvate of CO2. Thus, in estimating the contribution of a gluconeogenic substrate to glucose production by measuring the incorporation of label from the labelled substrate into glucose, dilution of label at the level of oxaloacetate is relatively small. Pyruvate cycling was as much as one-half the rate of conversion of pyruvate to oxaloacetate. Glucose and glutamate carbons were derived from oxaloacetate formed by similar pathways if not from a common pool. In the 60-h fasted subjects, over 80 % of glucose production was via gluconeogenesis. In the diabetic subjects the percentages averaged about 45 %. [Diabetologia (1995) 38: 831–838]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050360
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  • 2
    Electronic Resource
    Electronic Resource
    Glucose metabolism in a term infant with transient hyperinsulinism and high carbohydrate intake (1993)
    Springer
    European journal of pediatrics 152 (1993), S. 343-347 
    Details
    ISSN: 1432-1076
    Keywords: Hyperinsulinism ; Neonate ; Indirect calorimetry ; Glucose turnover
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Transient hyperinsulinaemia is a well-known cause of hypoglycaemia in newborn infants. The hypoglycaemia may be caused by a decreased glucose production and/or an increased glucose uptake. Whether the increased uptake is caused by increased glucose oxidation or increased non-oxidative disposal is not known. The aim of this study was to investigate the fate of the large amount of glucose infused in a term infant who developed hypoglycaemia due to transient hyperinsulinaemia shortly after birth and was treated with high glucose infusions. On day 6 an indirect calorimetry study was performed, together with a glucose turnover study. Carbohydrate intake was 13.6 mg/kg per minute (19.6 g/kg per day). Both studies were repeated on day 11, when carbohydrate intake was normalised to 7.8 mg/kg per minute (11.2 g/kg per day). Glucose oxidation was 28% higher and non-oxidative glucose disposal was 257% higher on day 6 as compared to day 11. Our results indicate that hypoglycaemia during hyperinsulinism is the result of increased non-oxidative disposal of glucose and not increased glucose oxidation. The results indicate a remarkable capacity of the newborn for lipogenesis during high carbohydrate intake.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01956750
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  • 3
    Electronic Resource
    Electronic Resource
    Rigorous management of insulin-dependent diabetes mellitus during pregnancy (1994)
    Springer
    Acta diabetologica 31 (1994), S. 126-129 
    Details
    ISSN: 1432-5233
    Keywords: Infant of diabetic mother ; Insulin-dependent diabetes mellitus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effect of rigorous management of insulin-dependent diabetes mellitus (IDDM) during pregnancy on the perinatal outcome was assessed by comparing 78 prepartum gravid patients with IDDM managed prospectively with 78 matched controls. The diabetic women were treated with insulin by either infusion pump or split-dose therapy, with the goal of normalization of the fasting blood sugars and hemoglobin Hb A1c values. Differences in the perinatal outcome were evaluated by either chi-square or analysis of variance. Of the women with IDDM, 14% where White class B, 43% class C, 26% class D, 17% classes R and F. The mean Hb A1c value in the first half of pregnancy was 8.49%±2.30%, and 7.34%±1.79% in the second half. Women with IDDM had higher rates of premature delivery (31% vs. 10%,P=0.003), pre-eclampsia (15% vs. 5%,P=0.035), and cesarean section (55% vs. 27%,P=0.002). Complications of infants born to diabetic mothers included large size for gestational age (41% vs. 16%,P=0.0002), hypoglycemia (14% vs. 1%,P=0.0025), hyperbilirubinemia (46% vs. 23%,P=0.0002), and respiratory distress (12% vs. 1%,P=0.008). The Apgar scores and mortality were similar. Congenital malformations occurred in 7.7% of infants of diabetic mothers and 1.3% of controls (P=0.05). The maternal Hb A1c level did not correlate with the infant size for gestation. Although the improved medical management of IDDM has decreased neonatal mortality, significant perinatal complications persist.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00570364
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    Paper (German National Licenses)
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