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  • 1
    ISSN: 1432-0428
    Keywords: Type 1 diabetes mellitus ; Glucagon ; Hepatic glucose production
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of glucagon infusion on hepatic glucose production during euglycaemia was evaluated in seven Type 1 (insulin-dependent) diabetic patients and in ten control subjects. In the diabetic subjects normoglycaemia was maintained during the night preceding the study by a variable intravenous insulin and glucose infusion. During the study endogenous insulin secretion was suppressed by somatostatin (450 μg/h) and replaced by insulin infusion (0.15 mU·kg−1·min−1). 3H-glucose was infused for isotopic determination of glucose turnover. Plasma glucose was clamped at 5 mmol/1 for 2 h 30 min and glucagon (1.5 ng· kg−1·min−1) was then infused for the following 3 h. Hepatic glucose production and glucose utilisation were measured during the first, second and third hour of the glucagon infusion. Basal hepatic glucose production (just prior to glucagon infusion) was similar in diabetic (1.2±0.3 mg·kg−1·min−1) and control (1.6±0.1 mg·kg−1·min−1) subjects. In diabetic patients hepatic glucose production rose slowly to 2.1±0.5 mg·kg−1·min−1 during the first hours of glucagon infusion and stabilized at this level (2.4±0.5 mg·kg−1·min−1) in the third hour. In control subjects hepatic glucose production increased sharply to higher levels than in the diabetic subjects (3.4±0.3 mg·kg−1·min−1) during the first and second hour of glucagon infusion (p〈0.05) and then gradually fell (2.9±0.4 mg·kg−1·min−1) during the third hour. In conclusion, when stimulated with glucagon at a physiologic plasma concentration diabetic patients had 1) an overall reduced hepatic glucose production response and 2) an abnormal sluggish response pattern. These abnormalities may imply inappropriate counter-regulation following a hypoglycaemic episode.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Diabetes ; diabetic neuropathy ; electrolytes ; hyperglycaemia ; nerve conduction ; somatostatin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Insufficient metabolic control in diabetes mellitus is associated with a reversible reduction in nerve conduction velocity, but the mechanism behind this phenomenon is unknown. To examine the effect of acute hyperglycaemia on nerve conduction eight non-diabetic men (20–49 years of age) with no signs of peripheral neuropathy were studied before and after 3 h of hyperglycaemic clamping (plasma glucose ≈ 15 mmol/l), while insulin secretion was suppressed by somatostatin [Study 1]. Nerve conduction velocity, as determined in the proximal part of the median nerve, fell by 2.8±3.0 m/s (2p-value: 0.033). However, during euglycaemic clamping (plasma glucose ≈ 5 mmol/l) in five non-diabetic men (19–38 years of age) infused solely with somatostatin [Study 2], a comparable decrement in nerve conduction velocity was found (1.7±1.3 m/s, 2p-value: 0.043). In both studies relative hypoinsulinaemia was present. Serum-sodium decreased significantly (143±1 mmol/l vs 137±1 mmol/l [Study 1] and 143±1 mmol/l vs 142±2 mmol/l [Study 2]), while serum-potassium increased. In conclusion, the slight but significant reduction in nerve conduction velocity observed in both studies appears to be correlated to electrolyte changes. However, an effect of hypersomatostatinaemia or the hormonal changes associated with this cannot be excluded, while short-term hyperglycaemia per se seems to be without effect on nerve conduction velocity.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0428
    Keywords: Key words Diabetes ; diabetic neuropathy ; electrolytes ; hyperglycaemia ; nerve conduction ; somatostatin.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Insufficient metabolic control in diabetes mellitus is associated with a reversible reduction in nerve conduction velocity, but the mechanism behind this phenomenon is unknown. To examine the effect of acute hyperglycaemia on nerve conduction eight non-diabetic men (20–49 years of age) with no signs of peripheral neuropathy were studied before and after 3 h of hyperglycaemic clamping (plasma glucose ≈ 15 mmol/l), while insulin secretion was suppressed by somatostatin [Study 1]. Nerve conduction velocity, as determined in the proximal part of the median nerve, fell by 2.8 ± 3.0 m/s (2p-value: 0.033). However, during euglycaemic clamping (plasma glucose ≈ 5 mmol/l) in five non-diabetic men (19–38 years of age) infused solely with somatostatin [Study 2], a comparable decrement in nerve conduction velocity was found (1.7 ± 1.3 m/s, 2p-value: 0.043). In both studies relative hypoinsulinaemia was present. Serum-sodium decreased significantly (143 ± 1 mmol/l vs 137 ± 1 mmol/l [Study 1] and 143 ± 1 mmol/l vs 142 ± 2 mmol/l [Study 2]), while serum-potassium increased. In conclusion, the slight but significant reduction in nerve conduction velocity observed in both studies appears to be correlated to electrolyte changes. However, an effect of hypersomatostatinaemia or the hormonal changes associated with this cannot be excluded, while short-term hyperglycaemia per se seems to be without effect on nerve conduction velocity. [Diabetologia (1994) 37: 1216–1220]
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0428
    Keywords: Hypoglycaemia ; counter-regulation ; glucose disposal ; muscle glycogen synthase activity ; glucose mass effect
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The purpose of the present study was to evaluate the role of muscle glycogen synthase activity in the reduction of glucose uptake during hypoglycaemia. Six healthy young men were examined twice; during 120 min of hyperinsulinaemic (1.5 mU · kg−1 · min−1) euglycaemia followed by: 1) 240 min of graded hypoglycaemia (plasma glucose nadir 2.8 mmol/l) or 2) 240 min of euglycaemia. At 350–360 min a muscle biopsy was taken and indirect calorimetry was performed at 210–240 and 330–350 min. Hypoglycaemia was associated with markedly increased levels of adrenaline, growth hormone and glucagon and also with less hyperinsulinaemia. During hypoglycaemia the fractional velocity for glycogen synthase was markedly reduced; from 29.8±2.3 to 6.4±0.9%, p〈0.05. Total glucose disposal was decreased during hypoglycaemia (5.58±0.55 vs 11.01±0.75 mg · kg−1 · min−1 (euglycaemia); p〈0.05); this was primarily due to a reduction of non-oxidative glucose disposal (2.43±0.41 vs 7.15±0.7 mg · kg−1 · min−1 (euglycaemia); p〈0.05), whereas oxidative glucose disposal was only suppressed to a minor degree. In conclusion hypoglycaemia virtually abolishes the effect of insulin on muscle glycogen synthase activity. This is in keeping with the finding of a marked reduction of non-oxidative glucose metabolism.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-5233
    Keywords: Glipizide ; Type 2 diabetes mellitus ; Glucose metabolism ; GLUT 4 ; Glycogen synthase activity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To examine whether sulphonylureas influence hyperglycaemia-induced glucose disposal and suppression of hepatic glucose production (HGP) in type 2 diabetes mellitus, a 150-min hyperglycaemic (plasma glucose 14 mmol/l) clamp with concomitant somatostatin infusion was used in eight type 2 diabetic patients before and after 6 weeks of glipizide (GZ) therapy. During the clamp a small replacement dose of insulin was given (0.15 mU/kg per min). Isotopically determined glucose-induced glucose uptake was similar before and after GZ administration which led to improved glycaemic control (basal plasma glucose 12.2±1.3 vs 8.9±0.7 mmol/l;P〈0.01). Glucose-induced suppression of HGP was, however, more pronounced during GZ treatment (0.96±0.14 vs 1.44±0.20 mg/kg per min;P〈0.02). Following GZ treatment hyperglycaemia failed to stimulate glycogen synthase activity. Moreover, GZ resulted in a significant increase in the immunoreactive abundance of the insulin-regulatable glucose transport protein (GLUT 4) (P〈0.02). In conclusion, these results suggest that GZ therapy in type 2 diabetic patients enhances hepatic sensitivity to hyperglycaemia, while glucose-induced glucose uptake remains unaffected. In addition, GZ tends to normalize the activity of glycogen synthase and increases the content of GLUT 4 protein in skeletal muscle.
    Type of Medium: Electronic Resource
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