Abnormal Regulation of Venous Alanine after Glucose Ingestion in Myotonic Dystrophy

1985 ◽  
Vol 68 (2) ◽  
pp. 151-157 ◽  
Author(s):  
Richard T. Moxley ◽  
William Kingston ◽  
Robert C. Griggs
Keyword(s):  
Amino Acids ◽  
Glucose Tolerance ◽  
Myotonic Dystrophy ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Oral Glucose Tolerance Testing ◽  
Glucose Ingestion ◽  
Normal Glucose ◽  
Normal Males ◽  
Slight Rise

1. The concentration of amino acids in whole blood was measured before and during standard 5 h oral glucose tolerance testing in six male patients with myotonic dystrophy and five normal males. The plasma levels of insulin and glucose were also determined. 2. From 90 to 240 min after glucose ingestion there was a striking decline in venous alanine concentration in the patients with myotonic dystrophy in contrast to a slight rise in alanine in the normal group. 3. The patients displayed normal glucose tolerance, and there was a sustained fall in the venous concentration of the insulin-sensitive amino acids comparable with that seen in the normal controls. However, the patients showed a threefold increase of plasma insulin after glucose. 4. These data indicate an abnormal regulation of alanine in myotonic dystrophy which may be the result of an alteration in muscle synthesis of this amino acid. This defect in alanine synthesis may be due to a decreased availability of intracellular pyruvate caused by the insulin resistance that exists in these patients.

scholarly journals A Clinic-based Approach to Diagnosis and Management of Prediabetes in High-risk Children and Adolescents

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Chelsea Lawson ◽  
S Naseeruddin Ahmed ◽  
Cassandra Brady ◽  
Ashley H Shoemaker
Keyword(s):  
High Risk ◽  
Glucose Tolerance ◽  
Best Practice ◽  
Fasting Glucose ◽  
Retrospective Chart Review ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Oral Glucose Tolerance Testing ◽  
Normal Glucose

Abstract Background Type 2 diabetes (T2D) in youth is increasing in prevalence. Diabetes screening is recommended for at-risk youth but best-practice strategies for management of pediatric prediabetes are unknown. This study leverages a pediatric prediabetes clinic to assess identification of high-risk patients, the rate of clinic follow-up and progression to T2D in youth over time. Methods Retrospective chart review of children referred to a single center for evaluation of prediabetes over a 3-year period. Measurements included hemoglobin A1c (HbA1C) and oral glucose tolerance testing. Patients were classified as normal glucose tolerance (NGT), impaired glucose tolerance (IGT) or T2D based on 2019 American Diabetes Association criteria. Patients classified as IGT/T2D were prescribed metformin. Results Of the 254 patients included; 25.6% had IGT and 6.7% had T2D. The IGT/T2D groups were older and more obese than the NGT group. There was a moderate correlation between HbA1C and fasting glucose (r = 0.59, P < 0.001); HbA1C and 2-hour glucose (r = 0.63, P < 0.001). Over the 3-year study, 52 of 82 patients with IGT/T2D (63%) returned for follow-up. Four patients regained NGT; 3 of those had isolated impaired fasting glucose (100 to 102 mg/dL). Three patients (4.6%) progressed from IGT to T2D over an average of 13 ± 6.2 months. In those patients, body mass index had increased 1.7 ± 2.3 kg/m2 from baseline. Conclusions A pediatric prediabetes clinic may allow for identification of high-risk youth but lost to follow-up rates are high. Continued weight gain is a risk factor for progression to T2D and effective weight management programs are needed.

ADRENAL ACTIVITY DURING NORMAL GLUCOSE TOLERANCE

1977 ◽  
Vol 84 (1) ◽  
pp. 115-118 ◽  
Author(s):  
Arthur J. Sober ◽  
Henry J. Ruder ◽  
Jonas Sode
Keyword(s):  
Glucose Tolerance ◽  
Plasma Cortisol ◽  
Normal Subjects ◽  
Tolerance Test ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Glucose Ingestion ◽  
Normal Glucose ◽  
Glucose Plasma

ABSTRACT Plasma cortisol was measured by radioimmunoassay during 4 h oral glucose tolerance tests in 8 non-obese normal subjects. Following 100 g of glucose, plasma cortisol concentrations were lower than basal at 15, 30 and 60 min, and declined with a half-time of 70 min. No evidence was obtained that the hyperglycaemia which follows glucose ingestion leads to increased cortisol secretion and that such a mechanism is involved in the stabilization of blood sugar levels during the posthyperglycaemic phase of the normal oral glucose tolerance test. Epinephrine and norepinephrine excretory rates during the hyperglycaemic (0–2 h) and euglycaemic (2–4 h) phases of the test were not significantly different. It is concluded that adrenocortical and adrenomedullary activities are not increased during normal glucose tolerance in man.

Glucose Tolerance in Patients with Cystic Fibrosis – Results from the German Cystic Fibrosis Registry

2020 ◽  
Vol 232 (04) ◽  
pp. 210-216
Author(s):  
Nicole Prinz ◽  
Julia Wosniok ◽  
Doris Staab ◽  
Manfred Ballmann ◽  
Christian Dopfer ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Glucose Tolerance ◽  
Real World ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Real World Data ◽  
Clinical Registries ◽  
Normal Glucose ◽  
Multivariable Regression ◽  
Adjusted Model

Abstract Background Oral glucose tolerance (OGT) deteriorates progressively in cystic fibrosis (CF). Clinical registries provide a unique basis to study real-world data. Patients & methods OGT tests (OGTTs) documented in the German CF-registry in 2016 were classified according WHO, modified by ADA: normal glucose tolerance (NGT), indeterminate glycaemia (INDET), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG+IGT, diabetes mellitus (DM). To study the association with lung function, multivariable regression adjusted for age, sex, and CFTR mutation was performed. Results Overall, OGTT screening was done in 35% of CF patients ≧10 years. Of the 996 patients (46.4% females; median age (IQR): 19 (14–27) years) with evaluable OGTTs, 56.2% had either NGT or INDET, whereas 34% had a pre-diabetic OGTT (IFG; IGT; IFG+IGT) and 9.8% a diabetic OGTT. 7 patients had glucose tolerance abnormalities <10 years. DM was more common in females or patients with F508del homozygote mutation, whereas IFG was more frequent in males (all p<0.05). Nearly 75% of patients after transplantation and about half with enteral/parental nutrition and/or steroid use had either a pre-diabetic or diabetic glucose tolerance. In the adjusted model, age (p<0.001) and OGTT category (p=0.013) had both a significant impact on %FEV1. Conclusion Our data of the German CF-registry highlights incidence of glucose tolerance abnormalities in second decade of life in CF patients. However, it also underlines the need for improvement of the documentation and/or performance of OGTT screening in real-world CF care.

Effects of exercise and lack of exercise on glucose tolerance and insulin sensitivity

1983 ◽  
Vol 55 (2) ◽  
pp. 512-517 ◽  
Author(s):  
G. W. Heath ◽  
J. R. Gavin ◽  
J. M. Hinderliter ◽  
J. M. Hagberg ◽  
S. A. Bloomfield ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Insulin Response ◽  
Insulin Binding ◽  
Normal Glucose Tolerance ◽  
Residual Effects ◽  
Oral Glucose ◽  
Glucose Load ◽  
Plasma Insulin Concentration ◽  
Normal Glucose ◽  
Blood Glucose Concentrations

Physically trained individuals have a markedly blunted insulin response to a glucose load and yet have normal glucose tolerance. This phenomenon has generally been ascribed to long-term adaptations to training which correlate with maximal oxygen uptake (VO2max) and reduced adiposity. Our study was undertaken to test the hypothesis that residual effects of the last bouts of exercise play an important role in this phenomenon. Eight well-trained subjects stopped training for 10 days. There were no significant changes in VO2max (58.6 +/- 2.2 vs. 57.6 +/- 2.1 ml/kg), estimated percent body fat (12.5 +/- 0.7 vs. 12.5 +/- 0.8%), or body weight. The maximum rise in plasma insulin concentration in response to a 100-g oral glucose load was 100% higher after 10 days without exercise than when the subjects were exercising regularly. Despite the increased insulin levels, blood glucose concentrations were higher after 10 days without exercise. Insulin binding to monocytes also decreased with physical inactivity. One bout of exercise after 11 days without exercise returned insulin binding and the insulin and glucose responses to an oral 100-g glucose load almost to the initial “trained” value. These results support our hypothesis.

Response of incretins (GIP and GLP-1) to an oral glucose load in female and male subjects with normal glucose tolerance

2014 ◽  
Vol 106 (2) ◽  
pp. e25-e29 ◽  
Author(s):  
Toshihiro Matsuo ◽  
Yoshiki Kusunoki ◽  
Tomoyuki Katsuno ◽  
Takashi Ikawa ◽  
Takafumi Akagami ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Oral Glucose Load ◽  
Glucose Load ◽  
Normal Glucose ◽  
Male Subjects

Urinary myo-inositol levels in Japanese schoolchildren with normal glucose tolerance

2016 ◽  
Vol 29 (2) ◽  
Author(s):  
Eiichiro Satake ◽  
Rie Matsushita ◽  
Kazuteru Kitsuda ◽  
Kohnosuke Ohtaka ◽  
Eiko Nagata ◽  
...  
Keyword(s):  
Early Detection ◽  
Glucose Tolerance ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Normal Range ◽  
Oral Glucose Tolerance Tests ◽  
Normal Glucose ◽  
Glucose Tolerance Tests ◽  
The Difference

AbstractUrinaryIn Study 1 (328 schoolchildren), fasting and postprandial UMI were measured, with ΔUMI defined as the difference between fasting and postprandial UMI levels. In Study 2, oral glucose tolerance tests and UMI measurements were conducted in 18 children with suspected having diabetes.For Study 1, ΔUMI was observed [−0.65 (−3.9, 1.35) mg/g creatinine]. For Study 2, children with diabetes or impaired glucose tolerance had a significantly higher ΔUMI than children with normal glucose tolerance.These studies demonstrated the normal range of UMI in children and possibility of a novel biomarker for early detection of glucose intolerance in children.

THE RESPONSE OF INFANTS OF DIABETIC WOMEN TO TOLBUTAMIDE AND LEUCINE AT BIRTH, AND TO GLUCOSE AND TOLBUTAMIDE AT 2 YEARS OF AGE

PEDIATRICS ◽  
1969 ◽  
Vol 43 (4) ◽  
pp. 546-557
Author(s):  
Mutya S. A. Velasco ◽  
Elsa P. Paulsen
Keyword(s):  
Glucose Tolerance ◽  
Plasma Glucose ◽  
Newborn Infants ◽  
Normal Glucose Tolerance ◽  
Diabetic Woman ◽  
Oral Glucose ◽  
Insulin Levels ◽  
Glucose Levels ◽  
Normal Glucose ◽  
Diabetic Mothers

Twelve newborn infants, 2 to 8 days old, of gestational (IGDM) and insulin-requiring (IDM) diabetic mothers responded to intravenous tolbutamide (20 mg/kg) with abnormally large decreases in plasma glucose and marked rises in plasma insulin (the latter was measured only in IGDM). Only 3 of 13 IGDM tested with leucine had significant decreases in plasma glucose. Newborn infants of normal mothers showed no changes in glucose or insulin in response to intravenous tolbutamide, and one of five had a small decrease in glucose levels after leucine. The results suggest the presence of large stores of pancreatic insulin in newborn infants of diabetic mothers which are more readily released by stimulation with tolbutamide than with leucine. The offspring of the diabetic women were restudied at 2 years of age for their response to intravenous tolbutamide and oral glucose. Seven of nine children had normal glucose and insulin levels after intravenous tolbutamide, and two had abnormally low glucose levels with high insulin levels. Three of the nine had normal glucose tolerance with normal insulin levels. The other six had abnormally elevated glucose levels which varied in duration from one-half to 2 hours. Four of the six had an accompanying hyperinsulinemia; two, who had diabetic glucose tolerance, had poor insulin responses. The findings in the 2-year-old children support a concept that the fetal environment provided by a diabetic woman has effects on carbohydrate tolerance which extend beyond the newborn period.

PLASMA CORTICOSTEROID, PLASMA INSULIN AND BLOOD SUGAR OF NORMAL FASTING AND DIABETIC SUBJECTS WITH OR WITHOUT HYPERCORTICISM

1968 ◽  
Vol 58 (4) ◽  
pp. 643-654 ◽  
Author(s):  
Vivian Harding Asfeldt ◽  
Kai R. Jørgensen
Keyword(s):  
Glucose Tolerance ◽  
Blood Sugar ◽  
Plasma Insulin ◽  
Insulin Response ◽  
Tolerance Test ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Acth Stimulation ◽  
Normal Glucose ◽  
Plasma Insulin Response

ABSTRACT Transient, maximum stimulation with β1–24 corticotrophin has been carried out in nine normal fasting subjects, in two fasting diabetics without hypercorticism and in three fasting diabetics with hypercorticism. Fluorimetric determinations of corticosteroids and determinations of immunological detectable insulin in plasma and blood sugar were made during stimulation. No significant variation in the blood sugar or the plasma insulin during transient, maximum ACTH stimulation was found either in normal fasting subjects or in fasting diabetics with or without hypercorticism. Moreover, in two diabetics with hypercorticism the plasma insulin response was measured during an oral glucose tolerance test. After treatment for approximately seven months with glucocorticosteroids, a reduced glucose tolerance and an increased plasma insulin response were found in one of these two patients. Four and a half months after the termination of steroid treatment, normal glucose tolerance and normal insulin responses were observed. In one patient, after several years of hypercorticism, a reduced glucose tolerance and a markedly reduced plasma insulin response were found.

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