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  • 1
    ISSN: 1432-0428
    Keywords: Insulin resistance ; insulin response ; maturity onset diabetes ; Aetiology of diabetes ; Heterogeneity of diabetes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Plasma insulin responses and insulin resistance were determined in 75 subjects, defined as having a normal, borderline abnormal, or abnormal oral glucose tolerance test (OGTT). Although considerable heterogeneity of insulin response existed, most patients with abnormal OGTT's had insulin responses greater than normal; none had insulin responses less than normal. The degree of insulin resistance also varied, but most patients with abnormal OGTT's were also abnormally insulin resistant. A significant correlation (r=0.64, p ±0.001) existed between insulin response and the degree of insulin resistance. However, when both variables were taken into consideration, the entire population could be divided into two groups. One group was characterized by both normal insulin responsiveness and sensitivity, the other by increased insulin response, associated with greater insulin resistance. Most patients with abnormal OGTT's fell into the latter group, but some had glucose intolerance without either an exaggerated insulin response or insulin resistance. These results suggest that true heterogeneity exists in patients with abnormal OGTT's.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Hypertriglyceridaemia ; fasting hyperglycaemia ; insulin ; diabetic hypertriglyceridaemia ; glucose ; insulin-independent diabetes ; very low density lipoprotein secretion rate ; triglycerides ; insulindependent diabetes ; non-esterified fatty acids
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Several aspects of lipid metabolism were studied to define the mechanism of hypertriglyceridaemia in insulin-independent diabetic patients with fasting hyperglycaemia. Patients with insulin-independent diabetes were more obese (p〈0.001) and had a significantly (p〈0.001) higher mean (± SEM) fasting plasma triglyceride concentration (387 ±66 mg/dl) than did either insulin-dependent diabetics (133±11 mg/dl) or normal (73±1 mg/dl) subjects. Very low density lipoprotein secretion rate was also significantly (p〈0.01 — 〈0.001) higher in patients with insulin-independent diabetes (14.65±1.37 mg/kg/h) as compared to 7.64±0.60 mg · kg/h and 9.86±0.75 mg/kg/h in normal subjects and patients with insulin-dependent diabetes, respectively. However, the relationship between plasma triglyceride concentration and very low density lipoprotein-triglyceride secretion was similar in diabetics and in normals. The diabetic groups had equivalent degrees of fasting and postprandial hyperglycaemia, and comparable elevations of fasting plasma nonesterified free fatty acid levels (insulin-independent = 0.72±0.07 mmol/L, insulin-dependent = 0.63±0.08 mmol/L). Postprandial plasma insulin concentrations, however, reached normal levels in insulin-independent diabetics and were higher (p〈0.001) than in insulin-dependent diabetics. Thus, hypertriglyceridaemia in insulin-independent diabetics with fasting hyperglycaemia was associated with increased hepatic very low density lipoprotein-triglyceride secretion, and normal plasma insulin levels. The lower triglyceride levels in the insulin-dependent diabetics is assumed to be due to their relative hypoinsulinaemia.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 16 (1979), S. 17-24 
    ISSN: 1432-0428
    Keywords: Chemical diabetes ; multidimensional analysis ; insulin resistance ; insulin secretion ; glucose intolerance ; diabetes mellitus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The relationship between chemical diabetes and overt diabetes in 145 nonobese adult subjects has been examined. The degree of glucose intolerance, insulin response to oral glucose, and insulin resistance in normal subjects and patients with nonketotic diabetes were first determined. These variables were then analyzed by a computer program which permits direct visualization of the three-dimensional shape of the data set. The picture obtained was that of a boomerang with two wings and a fat middle. The patients were then divided into three groups (normal, chemical diabetes, overt diabetes) on the basis of their oral glucose tolerance. Two-dimensional views of the relationship between the metabolic variables in these subjects resembled the initial three-dimensional image, i. e., a central core with two wings going off in opposite directions. The two wings represented patients with chemical diabetes and overt diabetes, respectively. Following this, the patients were reclassified on the basis of all three metabolic variables (plasma glucose response to oral glucose, plasma insulin response to oral glucose, and degree of insulin resistance) by means of a computer classification which employed a cluster analysis technique. This again resulted in the definition of three groups, in which there was a divergence between subjects classified as having chemical diabetes as contrasted to overt diabetes. This apparent separation between subjects with chemical and overt diabetes may explain why patients with chemical diabetes rarely develop overt diabetes.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 18 (1980), S. 335-340 
    ISSN: 1432-0428
    Keywords: Diabetes ; insulin deficiency ; hypertriglyceridaemia ; very low density liporotein ; hepatic perfusion ; triglycerides
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The relationship between varying degrees of insulin deficiency and hypertriglyceridaemia in rats have been examined. Rats were studied 7–10 days after injection with streptozotocin, and plasma glucose concentrations used to classify rats as having either moderate (200–350 mg/dl) or severe diabetes (〉 350 mg/dl). A 2- to 3-fold rise in plasma triglyceride (TG) concentration developed in six week old insulin deficient rats associated with elevated plasma non esterified fatty acid (NEFA) concentrations and decreased very low density lipoprotein secretion. Perfused livers from six week old rats with either moderate or severe diabetes were incapable of increasing hepatic TG secretion when perfusate NEFA concentrations were raised from 0.4 to 1.8 mmol/l. In one year old, spontaneously obese rats, an equivalent degree of hypertriglyceridaemia could be produced with a lesser degree of insulin deficiency, and in this instance very low density lipoprotein secretion was increased over control values. Hepatic TG secretion by perfused livers from these rats with moderate diabetes approximately doubled when perfusate NEFA concentration was raised from 0.40 to 0.85 mmol/l. These results emphasize the complex causality of diabetic hypertriglyeridaemia in situations characterised by comparable degrees of fasting hyperglycaemia.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 16 (1979), S. 173-177 
    ISSN: 1432-0428
    Keywords: Perfused liver ; hepatic insulin removal ; obesity ; hyperinsulinaemia ; hypoinsulinaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The t1/2 of insulin removal by perfused liver from hyperinsulinaemic ob/ob mice has previously been shown to be prolonged as compared to livers from nonobese mice. Since this defect improved when insulin levels were lowered in vivo, it appeared that the abnormality might be secondary to hyperinsulinaemia. To test this hypothesis further, insulin removal by perfused liver from one year and 6 week old Sprague-Dawley rats has been compared. Older rats were both obese and hyperinsulinaemic, and their t1/2 of insulin removal (mean ± SEM) was significantly prolonged (11.0±0.56 min vs 7.6±0.29 min). In addition, the induction of severe streptozotocin-induced hypoinsulinaemia in young rats led to a shortening of the t1/2 (5.56±0.72 min). However, the t1/2 also fell comparably when weight gain of young control rats was limited to that of young hypoinsulinaemic rats by caloric restriction (5.89±0.81 min). Furthermore, t1/2 was not increased when young rats were made hyperinsulinaemic by administration of NPH insulin for 12–14 days, nor was it decreased when older rats were made moderately hypoinsulinaemic by the administration of streptozotocin. These results demonstrate that the defect in hepatic insulin removal observed in the ob/ob mouse is not unique to this genetic variant, but is also observed in normal obese rats. Although the mechanism responsible for this phenomenon remains to be defined, it does not seem to be a simple function of relatively short-term (1–2 weeks) changes in plasma insulin concentration. On the other hand, it is still possible that the prolongation of insulin removal in both the ob/ob mouse and the obese rat is secondary to more chronic elevations in plasma insulin, or, alternatively is related to the obese state itself. In either event, the defect in hepatic insulin removal may be a general feature of obesity and, as such, contribute to the maintenance of hyperinsulinaemia in a variety of states characterized by obesity.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 21 (1981), S. 415-417 
    ISSN: 1432-0428
    Keywords: Streptozotocin ; exercise-training ; diabetic hypertriglyceridaemia ; insulin deficiency ; glucose ; triglyceride ; insulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Streptozotocin-induced insulin deficiency of a moderate degree was produced in exercise-trained and sedentary young rats, and determinations made of subsequent changes in plasma glucose, triglyceride, and insulin concentrations. Exercise-training attenuated the rise in both plasma glucose and triglyceride concentrations associated with insulin deficiency. Plasma insulin levels were, if anything, lower in exercise-trained rats. Thus, the beneficial effects of exercise-training on plasma glucose and triglyceride concentrations could not be due to the preservation of endogenous insulin secretion, and appear to be secondary to enhanced insulin sensitivity.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-0428
    Keywords: Type 2 diabetes mellitus ; low density lipoprotein ; lipoprotein binding ; lipoprotein degradation ; fibroblast, macrophage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Studies in vitro have shown that glycosylation of low density lipoprotein (LDL) will decrease its ability to bind to its receptor. We have evaluated the possibility that such an event might occur in vivo in diabetes by comparing the binding and degradation by normal fibroblasts and mouse peritoneal macrophages of LDL obtained from normal control subjects and patients with Type 2 (non-insulin-dependent) diabetes mellitus. When compared with control subjects, Type 2 diabetic patients had elevated fasting glucose (increased by 160%), haemoglobin A1c (increased by 75%), triglyceride (increased by 550%), and cholesterol (increased by 48%) levels. LDL from Type 2 diabetic patients displayed populations of particles with more heterogeneous hydrated densities than LDL from control subjects, with enrichment in the triglyceride content of the lighter population. 125I-LDL from normal and Type 2 diabetic subjects bound to fibroblasts with similar binding affinities and binding capacities. The kinetics of degradation of LDL from normal and Type 2 diabetic subjects by fibroblasts were also similar. Furthermore, all populations of LDL particles from Type 2 diabetic patients were bound and degraded by normal fibroblasts in identical fashions. In addition, 125I-LDL from normal and Type 2 diabetic subjects were not bound or degraded by mouse peritoneal macrophages. It is concluded that the LDL of patients with Type 2 diabetes with moderate hyperglycaemia are not modified sufficiently to alter their normal binding and degradation by human fibroblasts or to cause their uptake by mouse peritoneal macrophages.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-0428
    Keywords: Diabetes ; insulin deficiency ; hyperglycaemia ; insulin resistance ; insulin treatment ; alloxan
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Insulin resistance was measured in 16 normal dogs by a method involving the continuous intravenous infusion of epinephrine, propranolol, glucose and insulin. With this approach, endogenous insulin secretion is inhibited, similar steady state levels of exogenous insulin are achieved in all dogs, and the resultant steady state plasma glucose level provides a direct estimate of the ability of insulin to dispose of the infused glucose load. Thus, the higher the steady state plasma glucose level, the more the insulin resistance. Different amounts of alloxan were then administered to these dogs in order to produce insulin deficiency of varying degrees. Insulin resistance was then measured again in each dog. The results indicated that insulin resistance did not develop in dogs with only a moderate degree of insulin deficiency (fasting plasma glucose levels 〈 150 mg/100 ml). On the other hand, a significant degree of insulin resistance developed in dogs with severe insulin deficiency (fasting plasma glucose 〉 150 mg/100 ml). Furthermore, the insulin resistance that developed in dogs with severe insulin deficiency could be returned to normal with insulin replacement for one week. These results indicate that insulin resistance can occur as a secondary manifestation of insulin deficiency.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-0428
    Keywords: Hypertriglyceridaemia ; insulin resistance ; hyperinsulinaemia ; hepatic glucose output ; triglyceride metabolism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Plasma insulin response to oral glucose, insulin resistance, and insulin suppression of hepatic glucose production were studied in 11 normal subjects and 11 hypertriglyceridaemic patients. Patients with hypertriglyceridaemia had a significantly higher insulin response to oral glucose. Insulin resistance was also significantly greater in hypertriglyceridaemic subjects as determined by measuring the steady-state plasma glucose response during a continuous infusion of epinephrine, propranolol, glucose, and exogenous insulin. Insulin suppression of hepatic glucose production was calculated from the results of two studies in which glucose turnover rate was measured by a continuous infusion of3H-2-glucose. The first study was performed under conditions of basal insulin secretion, and the second carried out at steady state exogenous insulin levels of approximately 100 μU/ml. The results indicated that basal hepatic glucose production was the same in both groups, and was suppressed to an equal degree by physiological levels of insulin. These data demonstrate that hepatic glucose production can be suppressed to an equal degree in normal and hypertriglyceridaemic subjects at comparable circulating insulin levels, at the same time that resistance to insulin-stimulated glucose uptake is observed in the hypertriglyceridaemic individuals.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 19 (1980), S. 409-413 
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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