Effects of Exogenous Intravenous Glucose on Plasma Glucose and Lipid Homeostasis in Anesthetized Infants

1995 ◽  
Vol 83 (2) ◽  
pp. 258-263. ◽  
Author(s):  
Kahoru Nishina ◽  
Katsuya Mikawa ◽  
Nobuhiro Maekawa ◽  
Migiwa Asano ◽  
Hidefumi Obara
Keyword(s):  
Plasma Glucose ◽  
Glucose Concentration ◽  
Ketone Bodies ◽  
Plasma Concentrations ◽  
Plasma Glucose Concentration ◽  
Lipid Homeostasis ◽  
Intravenous Glucose ◽  
Nonesterified Fatty Acids ◽  
Minor Surgery ◽  
Glucose And Lipid Homeostasis

Background Whether intravenous glucose administration to infants during anesthesia is necessary remains to be resolved. The current study was designed to investigate the effect of exogenous glucose infusion on plasma glucose and lipid homeostasis in infants undergoing minor surgery. Methods Sixty infants (inpatients, ASA physical status 1) between 1 and 11 months of age were divided randomly into three groups as follows: LR group, lactated Ringer's solution (LR) alone; D2LR group, 2% glucose in LR; and D5LR group, 5% glucose in LR. Anesthesia was induced and maintained with halothane and nitrous oxide in oxygen. All fluids were infused at a rate of 6 ml.kg-1.h-1 until 1 h after surgery. Plasma concentrations of glucose, nonesterified fatty acids, ketone bodies, insulin, and cortisol were determined at induction of anesthesia, at the end of surgery, and 1 h after surgery. Results No infants in the three groups had hypoglycemia (< 50 mg.dl-1) throughout the study. In the LR group, plasma glucose concentration remained unchanged perioperatively compared with the basal values (at induction), whereas in the D2LR group, it increased during surgery but remained normoglycemic. In the D5LR group, plasma glucose concentration increased markedly both during and after surgery. In 6 of 20 infants, plasma glucose was greater than 200 mg.dl-1 at the end of surgery. In 8 of 20 infants receiving glucose-free infusion, plasma glucose concentrations decreased at the end of surgery. In contrast, the plasma glucose concentration increased in infants receiving glucose infusion. In the LR group, plasma concentrations of nonesterified fatty acids and ketone bodies increased at the end of and after surgery, suggesting lipid mobilization. The base excess decreased in the LR groups as concentration of the ketone bodies increased. Plasma insulin concentrations increased in the D2LR and D5LR groups and decreased after surgery in infants receiving a glucose-free solution. No intergroup differences in plasma cortisol concentrations existed at any sample point. Conclusions These data indicate that, in otherwise healthy infants undergoing minor surgery, intravenous infusion of 2% glucose may be sufficient to maintain plasma glucose concentrations within physiologic ranges and to prevent a compensatory increase in lipid mobilization (lipolysis) when fluids are infused at a rate of 6 ml.kg-1.h-1. However, there are limitations in extrapolating the results to neonates.

Effects of Oral Clonidine Premedication on Plasma Glucose and Lipid Homeostasis Associated with Exogenous Glucose Infusion in Children 

1998 ◽  
Vol 88 (4) ◽  
pp. 922-927 ◽  
Author(s):  
Kahoru Nishina ◽  
Katsuya Mikawa ◽  
Nobuhiro Maekawa ◽  
Makoto Shiga ◽  
Hidefumi Obara
Keyword(s):  
Plasma Glucose ◽  
Glucose Concentration ◽  
Ketone Bodies ◽  
Surgical Stress ◽  
Plasma Concentrations ◽  
Lipid Homeostasis ◽  
Nonesterified Fatty Acid ◽  
Oral Clonidine ◽  
Exogenous Glucose ◽  
Glucose And Lipid Homeostasis

Background Oral clonidine may influence plasma glucose and lipid homeostasis by modulating endocrinologic responses to surgical stress. The effect of oral clonidine premedication on plasma glucose and lipid homeostasis associated with exogenous glucose infusion were investigated in children undergoing minor surgery. Methods Otherwise healthy children (n, 120; aged 3-13 yr) were assigned randomly to six groups according to the glucose concentration of the intravenous solution (0%, 2%, or 5%, at a rate of 6 ml kg(-1) x h(-1)) and the preoperative medications (4 microg/kg clonidine or placebo given 100 min before anesthesia) they were to receive. The plasma concentrations of glucose, nonesterified fatty acid, ketone bodies, epinephrine, norepinephrine, and cortisol were determined. Results Infusion of 5% glucose caused hyperglycemia (mean glucose concentration >200 mg/dl) in six children receiving placebo and two receiving clonidine. Although the mean plasma glucose concentration increased in three placebo groups, it was unchanged and the plasma concentrations of total ketone bodies and nonesterified fatty acid were increased in children receiving clonidine and glucose-free solution. The plasma epinephrine, norepinephrine, and cortisol levels in children receiving placebo increased in response to surgery. Clonidine attenuated the increase in catecholamines and cortisol. Conclusions Oral clonidine premedication attenuated the hyperglycemic response, probably by inhibiting the surgical stress-induced release of catecholamines and cortisol. Infusion of 2% of glucose maintained plasma glucose concentrations within physiologic ranges in children receiving clonidine.

Effects of Exogenous Intravenous Glucose on Plasma Glucose and Lipid Homeostasis in Anesthetized Children

1991 ◽  
Vol 74 (6) ◽  
pp. 1017-1022 ◽  
Author(s):  
Katsuya Mikawa ◽  
Nobuhiro Maekawa ◽  
Ryokichi Goto ◽  
Osamu Tanaka ◽  
Hideaki Yaku ◽  
...  
Keyword(s):  
Plasma Glucose ◽  
Lipid Homeostasis ◽  
Intravenous Glucose ◽  
Glucose And Lipid Homeostasis

scholarly journals Orally administered, insulin-loaded amidated pectin hydrogel beads sustain plasma concentrations of insulin in streptozotocin-diabetic rats

2000 ◽  
Vol 164 (1) ◽  
pp. 1-6 ◽  
Author(s):  
CT Musabayane ◽  
O Munjeri ◽  
P Bwititi ◽  
EE Osim
Keyword(s):  
Plasma Glucose ◽  
Glucose Concentration ◽  
Plasma Insulin ◽  
Plasma Concentrations ◽  
Diabetic Rats ◽  
Plasma Glucose Concentration ◽  
Pharmacokinetic Parameters ◽  
Plasma Insulin Concentration ◽  
Hydrogel Beads ◽  
Concomitant Reduction

We report successful oral administration of insulin entrapped in amidated pectin hydrogel beads in streptozotocin (STZ)-diabetic rats, with a concomitant reduction in plasma glucose concentration. The pectin-insulin (PI) beads were prepared by the gelation of humilin-pectin solutions in the presence of calcium. Separate groups of STZ-diabetic rats were orally administered two PI beads (30 micrograms insulin) once or twice daily or three beads (46 micrograms) once daily for 2 weeks. Control non-diabetic and STZ-diabetic rats were orally administered pectin hydrogel drug-free beads. By comparison with control non-diabetic rats, untreated STZ-diabetic rats exhibited significantly low plasma insulin concentration (0.32+/-0. 03 ng/ml, n=6, compared with 2.60+/-0.44 ng/ml in controls, n=6) and increased plasma glucose concentrations (25.84+/-1.44 mmol/l compared with 10.72+/- 0.52 mmol/l in controls). Administration of two PI beads twice daily (60 micrograms active insulin) or three beads (46 micrograms) once a day to STZ-diabetic rats increased plasma insulin concentrations (0.89+/-0.09 ng/ml and 1.85+/- 0.26 ng/ml, respectively), with a concomitant reduction in plasma glucose concentration (15.45+/-1.63 mmol/l and 10.56+/-0.26 mmol/l, respectively). However, a single dose of PI beads (30 micrograms) did not affect plasma insulin concentrations, although plasma glucose concentrations (17.82+/-2.98 mmol/l) were significantly reduced compared with those in untreated STZ-diabetic rats. Pharmacokinetic parameters in STZ-diabetic rats show that the orally administered PI beads (30 micrograms insulin) were more effective in sustaining plasma insulin concentrations than was s.c. insulin (30 micrograms). The data from this study suggest that this insulin-loaded amidated pectin hydrogel bead formulation not only produces sustained release of insulin, but may also reduce plasma glucose concentration in diabetes mellitus.

FURTHER STUDIES ON THE EFFECT OF OCTANOATE ON GLUCOSE METABOLISM IN DOGS

1967 ◽  
Vol 45 (1) ◽  
pp. 29-38 ◽  
Author(s):  
Shafeek S. Sanbar ◽  
John R. Evans ◽  
Boniface Lin ◽  
Geza Hetenyi Jr.
Keyword(s):  
Glucose Metabolism ◽  
Intravenous Administration ◽  
Plasma Glucose ◽  
Glucose Concentration ◽  
Peripheral Blood ◽  
Plasma Insulin ◽  
Plasma Glucose Concentration ◽  
Intravenous Glucose ◽  
K Value ◽  
Healthy Dogs

Studies were carried out in anesthetized dogs to elucidate the mechanism of action of octanoate on glucose metabolism.Octanoate infusion in intact healthy dogs significantly decreased plasma glucose concentration, and in four out of seven dogs it raised plasma insulin concentration in peripheral blood. In contrast, intravenous administration of octanoate in four totally pancreatectomized dogs produced only small changes in plasma glucose concentration. These data suggest that the hypoglycemic action of octanoate may be mediated by increased secretion of insulin.The mean k value ([Formula: see text] of plasma glucose concentration) of intravenous glucose tolerance tests was significantly higher (2.38/minute) in healthy dogs that received an infusion of octanoate than in dogs that did not (1.2/minute). Octanoate also produced in healthy dogs greater increases in plasma insulin concentrations of peripheral blood during the tolerance tests. Furthermore, when delivered during a continuous intravenous administration of glucose (about 8 mg/kg per minute), octanoate infusion had no effect on either plasma glucose concentration or the rate of disappearance of glucose-U-14C from plasma to tissues. These findings indicate that octanoate does not impair glucose utilization in healthy dogs but actually improves tolerance of an intravenous glucose load, probably by stimulating greater release of insulin. These findings in vivo are discussed in the light of opposite effects of octanoate in vitro, to be described elsewhere, on glucose metabolism in the isolated heart and fat pad of rats.

scholarly journals Direct Chemical Measurement of the λ of the Lumped Constant of the [14C]Deoxyglucose Method in Rat Brain: Effects of Arterial Plasma Glucose Level on the Distribution Spaces of [14C]Deoxyglucose and Glucose and on λ

1989 ◽  
Vol 9 (3) ◽  
pp. 304-314 ◽  
Author(s):  
Kentaro Mori ◽  
Nancy Cruz ◽  
Gerald Dienel ◽  
Thomas Nelson ◽  
Louis Sokoloff
Keyword(s):  
Plasma Glucose ◽  
Glucose Concentration ◽  
Severe Hypoglycemia ◽  
Plasma Glucose Concentration ◽  
Operational Equation ◽  
Chemical Measurements ◽  
Lumped Constant ◽  
Dg Method ◽  
Arterial Plasma ◽  
Distribution Spaces

The lumped constant in the operational equation of the 2-[14C]deoxyglucose (DG) method contains the factor λ that represents the ratio of the steady-state tissue distribution spaces for [14C]DG and glucose. The lumped constant has been shown to vary with arterial plasma glucose concentration. Predictions based mainly on theoretical grounds have suggested that disproportionate changes in the distribution spaces for [14C]DG and glucose and in the value of λ are responsible for these variations in the lumped constant. The influence of arterial plasma glucose concentration on the distribution spaces for DG and glucose and on λ were, therefore, determined in the present studies by direct chemical measurements. The brain was maintained in steady states of delivery and metabolism of DG and glucose by programmed intravenous infusions of both hexoses designed to produce and maintain constant arterial concentrations. Hexose concentrations were assayed in acid extracts of arterial plasma and freeze-blown brain. Graded hyperglycemia up to 28 m M produced progressive decreases in the distribution spaces of both hexoses from their normoglycemic values (e.g., ∼ – 20% for glucose and – 50% for DG at 28 m M). In contrast, graded hypoglycemia progressively reduced the distribution space for glucose and increased the space for [14C]DG. The values for λ were comparatively stable in normoglycemic and hyperglycemic conditions but rose sharply (e.g., as much as 9–10-fold at 2 m M) in severe hypoglycemia.

scholarly journals Comparative Study of Fasting Plasma Glucose Concentration and Glucose Challenge Test for Screening Gestational Diabetes Mellitus

2014 ◽  
Vol 6 (2) ◽  
pp. 75-78
Author(s):  
Sujaya Sham ◽  
B Poornima R Bhat ◽  
Aruna Kamath
Keyword(s):  
Diabetes Mellitus ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Glucose Concentration ◽  
Challenge Test ◽  
Plasma Glucose Concentration ◽  
Fasting Plasma ◽  
Glucose Challenge Test ◽  
Glucose Challenge ◽  
Fasting Plasma Glucose Concentration

ABSTRACT Background To compare the sensitivity and specificity of fasting plasma glucose (FPG) with that of standard glucose challenge test (GCT). Materials and methods Eighty-nine eligible pregnant women underwent GCT between 24th and 28th gestational week, followed by a diagnostic 3 hours 100 gm oral glucose tolerance test within 1 week. Out patient clinic in Father Muller Medical College Hospital, Mangalore. Data was analyzed for significance by chi-square test. Results Fasting plasma glucose concentration at a threshold value of 90 mg/dl and GCT at recommended standard threshold of 140 mg/dl yielded sensitivities of 66.7% and 100% respectively and specificities of 87.3% and 46.5% respectively. Reducing the threshold value of FPG to 80 mg/dl increased the sensitivity of test to 91.7% with specificity of 54.9% which was comparable to standard GCT, in our study. Conclusion Measuring FPG concentration using a cut-off of. 80 mg/dl is an easier, tolerable and more cost effective procedure than GCT for detecting more severe cases of GDM, i.e. the diabetes mellitus group. In resource poor settings with population belonging to average risk or high risk category, FPG at a cut-off of 90 mg/dl can be used to screen GDM. How to cite this article Sham S, Bhat BPR, Kamath A. Comparative Study of Fasting Plasma Glucose Concentration and Glucose Challenge Test for Screening Gestational Diabetes Mellitus. J South Asian Feder Obst Gynae 2014;6(2):75-78.

A single bolus infusion of C-reactive protein increases gluconeogenesis and plasma glucose concentration in humans

Metabolism ◽  
2007 ◽  
Vol 56 (11) ◽  
pp. 1576-1582 ◽  
Author(s):  
Rakesh S. Birjmohun ◽  
Radjesh J. Bisoendial ◽  
Sander I. van Leuven ◽  
Mariette Ackermans ◽  
Aelko Zwinderman ◽  
...  
Keyword(s):  
Plasma Glucose ◽  
Glucose Concentration ◽  
Plasma Glucose Concentration ◽  
C Reactive Protein ◽  
Bolus Infusion ◽  
Single Bolus ◽  
Reactive Protein

Overnight inhibition of insulin secretion restores pulsatility and proinsulin/insulin ratio in type 2 diabetes

2000 ◽  
Vol 279 (3) ◽  
pp. E520-E528 ◽  
Author(s):  
Thomas Laedtke ◽  
Lise Kjems ◽  
Niels Pørksen ◽  
Ole Schmitz ◽  
Johannes Veldhuis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Plasma Glucose ◽  
Glucose Concentration ◽  
Plasma Glucose Concentration ◽  
Molar Ratio ◽  
Β Cell ◽  
First Phase Insulin Secretion ◽  
Clinical Experiments

Impaired insulin secretion in type 2 diabetes is characterized by decreased first-phase insulin secretion, an increased proinsulin-to-insulin molar ratio in plasma, abnormal pulsatile insulin release, and heightened disorderliness of insulin concentration profiles. In the present study, we tested the hypothesis that these abnormalities are at least partly reversed by a period of overnight suspension of β-cell secretory activity achieved by somatostatin infusion. Eleven patients with type 2 diabetes were studied twice after a randomly ordered overnight infusion of either somatostatin or saline with the plasma glucose concentration clamped at ∼8 mmol/l. Controls were studied twice after overnight saline infusions and then at a plasma glucose concentration of either 4 or 8 mmol/l. We report that in patients with type 2 diabetes, 1) as in nondiabetic humans, insulin is secreted in discrete insulin secretory bursts; 2) the frequency of pulsatile insulin secretion is normal; 3) the insulin pulse mass is diminished, leading to decreased insulin secretion, but this defect can be overcome acutely by β-cell rest with somatostatin; 4) the reported loss of orderliness of insulin secretion, attenuated first-phase insulin secretion, and elevated proinsulin-to-insulin molar ratio also respond favorably to overnight inhibition by somatostatin. The results of these clinical experiments suggest the conclusion that multiple parameters of abnormal insulin secretion in patients with type 2 diabetes mechanistically reflect cellular depletion of immediately secretable insulin that can be overcome by β-cell rest.

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