Counterregulatory hormones oscillate during steady-state hypoglycemia

1998 ◽  
Vol 275 (5) ◽  
pp. E821-E829 ◽  
Author(s):  
Pauline Genter ◽  
Nancy Berman ◽  
Mary Jacob ◽  
Eli Ipp
Keyword(s):  
Steady State ◽  
Plasma Glucose ◽  
Cardiovascular Responses ◽  
Large Magnitude ◽  
Counterregulatory Hormones ◽  
Glucose Levels ◽  
Clinical Observations ◽  
Serial Blood Sampling ◽  
The Mean ◽  
Glucose Reduction

During hypoglycemia, the magnitude of the counterregulatory response depends on the extent of plasma glucose reduction. However, our clinical observations during steady-state hypoglycemia indicate that symptom severity can change independently of plasma glucose concentrations, i.e., symptoms appeared to fluctuate despite stable glucose levels. This study was therefore designed to test the hypothesis that hormonal and symptomatic responses to hypoglycemia are pulsatile. Seven healthy subjects had serial blood sampling at 3-min intervals during 90 min of insulin-induced hypoglycemia. Mean ± SE plasma glucose levels plateaued at 62 ± 3 mg/dl. Counterregulatory hormones were significantly elevated ( P < 0.05–0.01, except norepinephrine) and strikingly pulsatile. Cluster analysis revealed pulses of large magnitude in plasma glucagon, epinephrine, and norepinephrine concentrations. Amplitudes were, respectively, 72 ± 4, 64 ± 8, and 48 ± 3% of the mean. Interpeak intervals were 27 ± 7, 19 ± 4, and 25 ± 5 min, respectively. Symptom score and cardiovascular responses were also pulsatile; their peaks were found to coincide with epinephrine peaks. We conclude that hormonal and symptomatic counterregulation in hypoglycemia, while critically driven by plasma glucose levels, is also influenced by an endogenous pulsatility that exists despite steady-state glucose concentrations.

The mean of fasting, 1-h, and 2-h plasma glucose levels is superior to each separate index in predicting diabetes

2021 ◽  
pp. 108650
Author(s):  
Duong Duc Pham ◽  
Young-Seon Lee ◽  
Shanyu Cui ◽  
Yunwan Jeon ◽  
Chae Hun Leem
Keyword(s):  
Plasma Glucose ◽  
Glucose Levels ◽  
The Mean

Glucose-Dependent Insulinotropic Polypeptide Is a Pancreatic Polypeptide Secretagogue in Humans

2019 ◽  
Vol 105 (3) ◽  
pp. e502-e510
Author(s):  
Simon Veedfald ◽  
Louise Vedtofte ◽  
Kirsa Skov-Jeppesen ◽  
Carolyn F Deacon ◽  
Bolette Hartmann ◽  
...  
Keyword(s):  
Pancreatic Polypeptide ◽  
Plasma Glucose ◽  
Exogenous Insulin ◽  
Healthy Individuals ◽  
Healthy Men ◽  
Glucose Levels ◽  
Fasting Glycemia ◽  
Islet Hormone ◽  
The Mean

Abstract Background Glucose-dependent insulinotropic polypeptide (GIP) has been suggested to stimulate the secretion of pancreatic polypeptide (PP), an islet hormone thought to regulate gut motility, appetite, and glycemia. Objective To determine whether human GIP1-42 (hGIP) stimulates PP secretion. Method As glycemia modulates the secretion of PP, we measured plasma PP concentrations from 2 studies in healthy men (n = 10) and in patients with type 2 diabetes (T2D) (n = 12), where hGIP1-42 had been administered intravenously during fasting glycemia, hyperglycemia (12 mmol/L), and insulin-induced hypoglycemia (targets: 2.5 mmol/L [healthy]; 3.5 mmol/L [T2D]). Porcine GIP1-42 (pGIP) was also infused intra-arterially in isolated porcine pancreata (n = 4). Results Mean fasting plasma glucose concentrations were approximately 5 mmol/L (healthy) and approximately 8 mmol/L (T2D). At fasting glycemia, PP concentrations were higher during intravenous hGIP1-42 infusion compared with saline in healthy men (mean [standard error of the mean, SEM], net incremental areas under the curves (iAUCs)[0-30min], 403 [116] vs –6 [57] pmol/L × min; P = 0.004) and in patients with T2D (905 [177] vs –96 [86] pmol/L × min; P = 0.009). During hyperglycemic clamping, mean [SEM] PP concentrations were significantly higher during hGIP1-42 infusion compared with saline in patients with T2D (771 [160] vs –183 [117] pmol/L × min; P = 0.001), but not in healthy individuals (–8 [86] vs –57 [53] pmol/L × min; P = 0.69). When plasma glucose levels were declining in response to exogenous insulin, mean [SEM] PP concentrations were higher during hGIP1-42 infusion compared with saline in healthy individuals (294 [88] vs –82 [53] pmol/L × min; P = 0.0025), but not significantly higher in patients with T2D (586 [314] vs –120 [53]; P = 0.070). At target hypoglycemia, PP levels surged in both groups during both hGIP1-42 and saline infusions. In isolated pancreata, pGIP1-42 increased mean [SEM] PP output in the pancreatic venous effluent (baseline vs infusion, 24[5] vs 79 [16] pmol/min x min; P = 0.044). Conclusion GIP1-42 increases plasma PP secretion in healthy individuals, patients with T2D, and isolated porcine pancreata. Hyperglycemia blunts the stimulatory effect of hGIP1-42 in healthy individuals, but not in patients with T2D.

scholarly journals Simultaneous measurement of glucose transport and utilization in the human brain

2011 ◽  
Vol 301 (5) ◽  
pp. E1040-E1049 ◽  
Author(s):  
Alexander A. Shestov ◽  
Uzay E. Emir ◽  
Anjali Kumar ◽  
Pierre-Gilles Henry ◽  
Elizabeth R. Seaquist ◽  
...  
Keyword(s):  
Steady State ◽  
Human Brain ◽  
Kinetic Parameters ◽  
Glucose Transport ◽  
Plasma Glucose ◽  
Data Extraction ◽  
Glucose Levels ◽  
H Nmr ◽  
Time Courses ◽  
State Models

Glucose is the primary fuel for brain function, and determining the kinetics of cerebral glucose transport and utilization is critical for quantifying cerebral energy metabolism. The kinetic parameters of cerebral glucose transport, K M t and Vmax t, in humans have so far been obtained by measuring steady-state brain glucose levels by proton (1H) NMR as a function of plasma glucose levels and fitting steady-state models to these data. Extraction of the kinetic parameters for cerebral glucose transport necessitated assuming a constant cerebral metabolic rate of glucose ( CMR glc) obtained from other tracer studies, such as 13C NMR. Here we present new methodology to simultaneously obtain kinetic parameters for glucose transport and utilization in the human brain by fitting both dynamic and steady-state 1H NMR data with a reversible, non-steady-state Michaelis-Menten model. Dynamic data were obtained by measuring brain and plasma glucose time courses during glucose infusions to raise and maintain plasma concentration at ∼17 mmol/l for ∼2 h in five healthy volunteers. Steady-state brain vs. plasma glucose concentrations were taken from literature and the steady-state portions of data from the five volunteers. In addition to providing simultaneous measurements of glucose transport and utilization and obviating assumptions for constant CMR glc, this methodology does not necessitate infusions of expensive or radioactive tracers. Using this new methodology, we found that the maximum transport capacity for glucose through the blood-brain barrier was nearly twofold higher than maximum cerebral glucose utilization. The glucose transport and utilization parameters were consistent with previously published values for human brain.

scholarly journals Glucometers for Patients with Type 2 Diabetes Mellitus: Are they helpful?

2021 ◽  
Vol 9 (2) ◽  
pp. 140-144
Author(s):  
Andrew Thomas ◽  
Mohan T. Shenoy ◽  
K.T. Shenoy ◽  
Nirmal George
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Plasma Glucose ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Glucose Levels ◽  
The Mean ◽  
Glycated Hemoglobin Level

Background: The effectiveness of self-monitoring of blood glucose (SMBG) in type 2 diabetes mellitus (T2DM) patients is debated in the literature. We aimed at elucidating the association and patterns of complications between SMBG use and plasma glucose values. Methods: This cross-sectional study comprised 303 participants from outpatient departments with T2DM for over 12 months. We analyzed sociodemographic and clinical variables including: anthropometry, SMBG use, disease duration, treatment modality, complications, plasma glucose level, and glycated hemoglobin level (%). Results: The mean duration of T2DM was 93±76 months. Participants were grouped into SMBG users (n=115, 38%) and non-SMBG users (n=188, 62%). The mean fasting plasma glucose levels of SMBG and non-SMBG users were 140.7±42.7 (95% Confidence Interval [95%CI]: 132.72;148.67) mg/dl and 145.4±50 (95%CI: 138.12;152.67) mg/dl (p=0.03), respectively. The mean post-prandial plasma glucose levels of the SMBG and non-SMBG groups were 202±63.42 (95%CI: 190.23;213.76) mg/dl and 209±84.54 (95%CI: 196.56;221.43) mg/dl (p=0.002), respectively. The mean difference in HbA1c among the groups were 8.14±1.69% (95%CI: 7.59;8.68) and 8.15±1.98% (95%CI: 7.27;9.02) (p=0.4), respectively. Hypoglycemia (n=50, 43.5%) was the most common complication. The prevalence of neuropathy (n=5, 4.3%, p=0.036) and cardiovascular disease (n=21, 18.3%, p=0.042) were significantly higher in the SMBG group. Conclusion: Although plasma glucose values were significantly lower in the SMBG group, its clinical significance remains questionable. Furthermore, many participants in both the groups had shortfalls in awareness, monitoring, and glycemic control. SMBG use needs to be evaluated in a cohort of patients with T2DM with adequate health awareness.

Effect of Academic Activities on Plasma Cortisol, Glucose Levels and Body Mass Index in Students of College of Health Sciences, Nnamdi Azikiwe Uiversity, Nnewi Campus, Anambra State, Nigeria

2018 ◽  
Vol 4 (01) ◽  
Author(s):  
Analike Rosemary Adamma ◽  
Dibor Henry Onyedika ◽  
Ogbodo Emmanuel Chukwuemeka ◽  
Ezeugwunne Ifeoma Priscilla ◽  
Amah Ubuo Kalu ◽  
...  
Keyword(s):  
Cortisol Level ◽  
Plasma Glucose ◽  
Plasma Cortisol ◽  
Plasma Glucose Level ◽  
Serum Cortisol ◽  
Academic Stress ◽  
Anambra State ◽  
Glucose Levels ◽  
Academic Activities ◽  
The Mean

Academic activities have been described as a naturalistic stressor capable of affecting human health. This study investigated the effect of academic activities on plasma cortisol, glucose levels and body mass index in students of College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria. A total number of 60 male subjects were recruited for this study. They were grouped into 2 stages (3 and 8 weeks) of intensive academic stress respectively. Thereafter, 5mls of blood sample was collected from the subjects into fluoride oxalate and lithium heparin containers respectively and used for analysis of biochemical parameters. Serum cortisol was assayed using ELISA method, whereas plasma glucose level was assayed using enzymatic method. Anthropometric parameters of the subjects were obtained using a well-structured questionnaire. Result showed that the mean plasma glucose level in 8 weeks was significantly higher (4.64±0.23) compared with 3 weeks (4.06±0.20) of academic stress (P<0.05). Again, the mean serum cortisol level was significantly higher in 8weeks (415.00±16.54) compared with 3 weeks (398.00±10.51) of subjects exposure to academic stress (P<0.05). Meanwhile, there was a significant decrease in the mean BMI of the subjects in 8weeks of examination (23.50±3.25) when compared to 3 weeks (24.51±4.10) (P<0.05). This study also revealed a significant positive correlation between Plasma glucose and serum cortisol levels (r= 0.184; P=0.002), BMI and cortisol level (r= 0.253; P=0.004) of the participants after 3weeks of academic stress. More so, at 8 weeks of academic stress, there was a significant positive correlation between mean plasma glucose and serum cortisol levels (r= 0.240; P=0.001) and between BMI and cortisol level (r= 0.151; P=0.000). This study showed that the mean levels of serum cortisol and plasma glucose increases with increasing duration of academic activities, whereas, BMI decreases with increase in the duration of academic stress.

scholarly journals Early insulin sensitivity after restrictive bariatric surgery, inconsistency between HOMA-IR and steady-state plasma glucose levels

2010 ◽  
Vol 6 (4) ◽  
pp. 340-344 ◽  
Author(s):  
Francois M.H. van Dielen ◽  
Jeroen Nijhuis ◽  
Sander S.M. Rensen ◽  
Nicolaas C. Schaper ◽  
Janneke Wiebolt ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Steady State ◽  
Insulin Sensitivity ◽  
Plasma Glucose ◽  
Glucose Levels ◽  
Restrictive Bariatric Surgery ◽  
State Plasma

Association of serum glycated albumin to haemoglobin A1C ratio with hepatic function tests in patients with chronic liver disease

2009 ◽  
Vol 46 (5) ◽  
pp. 368-372 ◽  
Author(s):  
Yukihiro Bando ◽  
Hideo Kanehara ◽  
Daisyu Toya ◽  
Nobuyoshi Tanaka ◽  
Soji Kasayama ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Plasma Glucose ◽  
Glycated Albumin ◽  
Hepatic Function ◽  
Chronic Liver ◽  
Diabetic Patients ◽  
Haemoglobin A1c ◽  
Glucose Levels ◽  
The Mean

Background In patients with chronic liver disease (CLD), glycated haemoglobin (HbA1C) levels have been shown to be apparently lower than real values, whereas serum glycated albumin (GA) levels are apparently higher. The present study was aimed to examine whether both glycaemic indices are influenced by hepatic function. Methods Subjects consisted of 82 patients with CLD. Various indicators for hepatic function as well as HbA1C and GA were also measured. Estimated HbA1C values were calculated from the mean plasma glucose levels. Two hundred and two type 2 diabetic patients without CLD were studied as controls. Results Although GA was strongly correlated with HbA1C in patients with CLD as well as diabetic patients, GA levels in patients with CLD were relatively higher than those in diabetic patients. In patients with estimated HbA1C ≤5.8%, GA levels significantly increased but HbA1C levels decreased as a function of decreasing hepaplastin test (HPT). The ratio of GA/HbA1C (G/H ratio) increased as a function of decreasing HPT. In patients with estimated HbA1C >5.8%, in contrast, GA levels were independent of HPT levels. In the patients with CLD, GA and HbA1C were associated with mean plasma glucose levels and some indicators for hepatic function. The multivariate analysis revealed a significant association of G/H ratio with HPT, cholinesterase and direct bilirubin. The G/H ratio was not associated with the mean plasma glucose but with HPT and cholinesterase levels. Conclusions The G/H ratio correlates with hepatic function but not with plasma glucose levels. Therefore, CLD should be suspected for diabetic patients with an elevated G/H ratio.

scholarly journals NMR Determination of Intracerebral Glucose Concentration and Transport Kinetics in Rat Brain

1992 ◽  
Vol 12 (3) ◽  
pp. 448-455 ◽  
Author(s):  
Graeme F. Mason ◽  
Kevin L. Behar ◽  
Douglas L. Rothman ◽  
Robert G. Shulman
Keyword(s):  
Steady State ◽  
Plasma Glucose ◽  
Glucose Concentration ◽  
Goodness Of Fit ◽  
Glucose Consumption ◽  
Plasma Glucose Concentration ◽  
Transport Parameters ◽  
Glucose Levels ◽  
Normal Glucose ◽  
Wet Weight

The concentration of intracerebral glucose as a function of plasma glucose concentration was measured in rats by 13C NMR spectroscopy. Measurements were made in 20–60 min periods during the infusion of [1-13C]d-glucose, when intracerebral and plasma glucose levels were at steady state. Intracerebral glucose was found to vary from 0.7 to 19 μmol g−1 wet weight as the steady-state plasma glucose concentration was varied from 3 to 62 m M. A symmetric Michaelis–Menten model was fit to the brain and plasma glucose data with and without an unsaturable component, yielding the transport parameters Km, Vmax, and Kd. If it is assumed that all transport is saturable ( Kd = 0), then Km = 13.9 ± 2.7 m M and Vmax/ Vgly = 5.8 ± 0.8, where Vgly is the rate of brain glucose consumption. If an unsaturable component of transport is included, the transport parameters are Km = 9.2 ± 4.7 m M, Vmax/ Vgly = 5.3 ± 1.5, and Kd/ Vgly = 0.0088 ± 0.0075 ml μmol−1. It was not possible to distinguish between the cases of Kd = 0 and Kd > 0, because the goodness of fit was similar for both. However, the results in both cases indicate that the unidirectional rate of glucose influx exceeds the glycolytic rate in the basal state by 2.4-fold and as a result should not be rate limiting for normal glucose utilization.

scholarly journals Comparative study of anthropometric measurements, liver function tests, hemoglobin and plasma glucose levels between individuals with alcohol abuse and controls

2019 ◽  
Vol 6 (4) ◽  
pp. 1064
Author(s):  
P. C. Lalramenga ◽  
Honey Satish Savla ◽  
Naveen P.
Keyword(s):  
Alcohol Abuse ◽  
Liver Function ◽  
Plasma Glucose ◽  
Serum Bilirubin ◽  
Liver Function Tests ◽  
Anthropometric Measurements ◽  
Years Of Life Lost ◽  
Glucose Levels ◽  
Function Tests ◽  
The Mean

Background: Alcohol abuse is global burden to families as well as society. On the ‘years of life lost scale’, which is based on alcohol attributable years of life lost, India has been rated 4 on a scale of 1 to 5. This implies that the alcohol consuming population of our country loses most of the years of their life because of drinking and its consequences. The aim of this research is to compare anthropometric measurements, liver function tests, haemoglobin and plasma glucose levels in individuals with alcohol abuse and normal population.Methods: The study was conducted in the Department of General Medicine, Civil Hospital, Aizawl. 84 cases of individuals with alcohol abuse (as per DSM-IV criteria) within the age group of 18-70 years and 70 age, sex, height and weight matched lifetime abstainers, healthy individuals were taken as controls from medicine department. They underwent a detailed clinical examination, anthropometric measurements, liver function tests, haemoglobin and plasma glucose levels.Results: 15.5% of the individuals with alcohol abuse had hypertension. The mean post prandial glucose among the individuals with alcohol abuse was 116.8±12.3 mg/dl and among the controls was 121.1±11.0 mg/dl. Mean serum bilirubin 1.1 mg/dl, AST 79 IU/l & ALT was 79.6 in alcoholics. The mean serum bilirubin 0.8 mg/dl, AST 27.2 IU/l and ALT was 29.4 in non-alcoholics.Conclusions: The individuals with alcohol abuse have raised serum bilirubin, AST and ALT levels compared to the non-alcoholics. Prevalence of hypertension is higher in the individuals with alcohol abuse compared to normal population.

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