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  • 1
    Electronic Resource
    Electronic Resource
    Physical exercise and fuel homeostasis in diabetes mellitus (1978)
    Springer
    Diabetologia 14 (1978), S. 213-222 
    Details
    ISSN: 1432-0428
    Keywords: Body substrate depots ; fuel homeostasis ; physical exercise ; diabetes mellitus ; glucoregulatory hormones ; muscle glycogen ; liver glycogen ; gluconeogenesis ; glycogenolysis ; ketogenesis ; blood glucose ; FFA ; ketone bodies ; amino acids
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary During the initial phase of physical exercise muscle glycogen is the primary source of fuel for contracting muscle in normal man. When exercise continues beyond the first 5–10 min blood glucose and free fatty acids (FFA) become increasingly important substrates. Glucose utilization may account for 25–35% of the total substrate supply during mild to moderately heavy exercise. The augmented glucose utilization by working muscle is balanced by a rise in hepatic glucose production. The latter is achieved primarily by hepatic glycogenolysis during brief work, but during prolonged exercise gluconeogenesis may account for as much as 40–50% of the hepatic glucose output. Muscle uptake of FFA is determined primarily by its availability to the working muscle, and it may account for 30–60% of the total fuel supply. Ketone bodies are not utilized by working muscle in normal man. In patients with diabetes mellitus the metabolic effects of physical exercise are to a large extent determined by the time interval between insulin administration and the onset of exercise. Thus, in insulin treated patients with mild hyperglycaemia and no or minimal ketonaemia the utilization of glycogen, blood glucose and FFA by working muscle is similar to that of healthy subjects, and exercise is accompanied by a fall in blood glucose levels. In contrast, patients with more marked hyperglycaemia and hyperketonaemia may respond to exercise with a further rise in both blood glucose and ketone body levels, reflecting augmented rates of hepatic gluconeogenesis as well as ketogenesis. The repletion of muscle and liver glycogen, which takes place for 24–48 h after exercise, requires — besides carbohydrate feeding — a minimum concentration of insulin. Glycogen resynthesis probably accounts for a major part of the empirically well established beneficial effect of physical exercise in diabetic patients. The above considerations underscore the importance of adequate insulin administration in connection with exercise in diabetic patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01219419
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  • 2
    Electronic Resource
    Electronic Resource
    Normalization of hepatic glucose regulation despite systemic insulin delivery. Studies in patients with pancreatic transplantation for Type 1 (insulin-dependent) diabetes mellitus (1991)
    Springer
    Diabetologia 34 (1991), S. 345-349 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 (insulin-dependent) diabetes mellitus ; pancreatic transplantation ; hepatic glucose regulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary With current surgical techniques for pancreatic transplantation, the graft is anastomosed to the iliac vessels, resulting in delivery of insulin to the systemic circulation rather than to the portal vein as in healthy man. The possible influence of the altered route of insulin delivery on the regulation of splanchnic glucose metabolism was studied in four patients with Type 1 (insulin-dependent) diabetes mellitus at 6–19 months after combined pancreatic and kidney transplantation. Four non-diabetic, age-matched renal transplant recipients and two groups of age-matched healthy subjects served as controls. The studies were carried out in the basal state and during two rates of intravenous glucose infusion (2 and 4 mg · kg−1 · min−1). Fasting arterial glucose and splanchnic glucose output was similar in all groups. Basal hyperinsulinaemia was present in pancreatic graft recipients compared to healthy subjects. During low rate intravenous glucose infusion splanchnic glucose output decreased to a similar extent in all groups. With the higher glucose infusion rate (4 mg · kg−1 · min−1) a net glucose uptake was observed which was similar in all three groups. Peripheral glucose uptake was unchanged at the lower glucose infusion rate but increased by 45–55% at the higher rate. It is concluded that despite systemic insulin delivery from a heterotopic pancreatic graft, hepatic glucose metabolism appears normal both in the post-absorptive state and in response to glucose-stimulated endogenous insulin secretion. Portal insulin delivery is thus not necessary for normal hepatic glucose metabolism in the Type 1 diabetic patient.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00405007
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  • 3
    Electronic Resource
    Electronic Resource
    INTERACTION OF LEUCINE, GLUCOSE, AND KETONE METABOLISM IN RAT BRAIN IN VITRO (1979)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of neurochemistry 32 (1979), S. 0 
    Details
    ISSN: 1471-4159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Brain cortex slices from fed, 48 h and 120 h fasted rats were incubated and 14CO2 was measured from (a) [U-14C]glucose (5 mm) either alone or in the presence of l-lcucine (0.1 or 1 mm), and (b) [U-14C]leucine or [l-14C]leucine at 0.1 or 1 mm with or without glucose (5 mm). In other experiments, sodium dl-3-hydroxybutyrate (3-OHB) or acetoacetate (AcAc) at 1 or 5 mm were added in the above incubation mixture. The rate of conversion of [U14C]glucose to CO2 was decreased 20% by leucine at 1 mm and 30–50% by 3-OHB at 1 or 5 mm but not by leucine at 0.1 mm. The effects of 3-OHB and of leucine (1 mm) were not additive. The effects of leucine were similar in the fed and fasted rats. The rate of conversion of [U-14C]leucine or [l-,4C]leucine to 14CO2 at 0.1 mm and 1.0 mm was increased by glucose (35%) in the fed or fasted rats. Ketone bodies in the absence of glucose had no effect on leucine oxidation. However, the stimulatory effect of glucose on the rate of conversion of leucine to CO2 was inhibited by 3-OHB at 5 mm. These results suggest that (a) leucine in increased concentrations (1 mm) may reduce glucose oxidation by brain cortex while itself becoming an oxidative fuel for brain, and (b) leucine oxidation by brain may be influenced by the prevailing glucose and ketone concentrations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-4159.1979.tb04510.x
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  • 4
    Electronic Resource
    Electronic Resource
    Amino Acid Metabolism in Man (1975)
    Palo Alto, Calif. : Annual Reviews
    Annual Review of Biochemistry 44 (1975), S. 933-955 
    Details
    ISSN: 0066-4154
    Source: Annual Reviews Electronic Back Volume Collection 1932-2001ff
    Topics: Chemistry and Pharmacology , Biology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1146/annurev.bi.44.070175.004441
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  • 5
    Electronic Resource
    Electronic Resource
    ENDOCRINE EVALUATION IN THALASSEMIA MAJOR (1974)
    Oxford, UK : Blackwell Publishing Ltd
    Annals of the New York Academy of Sciences 232 (1974), S. 0 
    Details
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1749-6632.1974.tb20589.x
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