scholarly journals Higher Endogenous Glucose Production During OGTT vs Isoglycemic Intravenous Glucose Infusion

2016 ◽  
Vol 101 (11) ◽  
pp. 4377-4384 ◽  
Author(s):  
Asger Lund ◽  
Jonatan I. Bagger ◽  
Mikkel Christensen ◽  
Magnus Grøndahl ◽  
Gerrit van Hall ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Hemoglobin A1c ◽  
Glucose Production ◽  
Endogenous Glucose Production ◽  
Oral Glucose ◽  
Control Subjects ◽  
Nondiabetic Control ◽  
Endogenous Glucose

Context: Oral glucose ingestion elicits a larger insulin response and delayed suppression of glucagon compared to isoglycemic IV glucose infusion (IIGI). Objective: We studied whether these differences translate into effects on endogenous glucose production (EGP) and glucose disposal in patients with type 2 diabetes and nondiabetic control subjects. Design: This was a single-blinded, randomized, crossover study. Setting: The study was conducted at a specialized research unit. Participants: Ten patients with type 2 diabetes (age, [mean ± SD] 57.1 ± 6.7 years; body mass index, 29.0 ± 4.3 kg/m2; hemoglobin A1c, 53.8 ± 11.0 mmol/mol; duration of diabetes, 9.2 ± 5.0 years) and 10 matched nondiabetic control subjects (age, 56.0±10.7 years; body mass index, 29.8 ± 2.9 kg/m2; hemoglobin A1c, 33.8 ± 5.5 mmol/mol) participated. Interventions: Three experimental days: 75 g-oral glucose tolerance test (OGTT), IIGI, and IIGI+glucagon (IIGI with a concomitant IV glucagon infusion [0.8 ng/kg/min from 0 to 25 minutes] designed to mimic portal glucagon concentrations during OGTT in the type 2 diabetic group) were undertaken. Main Outcome Measures: Glucose kinetics were assessed by tracer methodology. Results: Glucose rate of disappearance was higher during the OGTT vs IIGI in the control group, but similar on all days in the diabetic group. Surprisingly, in both groups, EGP was more suppressed during IIGI than during OGTT, and exogenous glucagon infusion during IIGI did not restore EGP to the levels observed during OGTT. Conclusion: EGP was less suppressed during OGTT than during IIGI in both patients with type 2 diabetes and in nondiabetic control subjects. Based on the present experimental design, it was not possible to attribute this difference to the delayed glucagon suppression observed in the initial phase of the OGTT.

scholarly journals Mechanisms for the Antihyperglycemic Effect of Sitagliptin in Patients with Type 2 Diabetes

2012 ◽  
Vol 97 (8) ◽  
pp. 2818-2826 ◽  
Author(s):  
Elza Muscelli ◽  
Arturo Casolaro ◽  
Amalia Gastaldelli ◽  
Andrea Mari ◽  
Giuseppe Seghieri ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cell Function ◽  
Glucose Production ◽  
Endogenous Glucose Production ◽  
Oral Glucose ◽  
Incretin Effect ◽  
Β Cell ◽  
Endogenous Glucose ◽  
Cell Glucose

Abstract Context: Dipeptidyl peptidase IV (DPP-4) inhibitors improve glycemic control in patients with type 2 diabetes. The underlying mechanisms (incretin effect, β-cell function, endogenous glucose production) are not well known. Objective: The aim of the study was to examine mechanisms of the antihyperglycemic effect of DPP-4 inhibitors. Design, Setting, and Patients: We administered a mixed meal with glucose tracers ([6,6-2H2]-glucose infused, [1-2H]-glucose ingested), and on a separate day, a glucose infusion matched the glucose responses to the meal (isoglycemic test) in 50 type 2 diabetes patients (hemoglobin A1c = 7.4 ± 0.8%) and seven controls; 47 diabetic completers were restudied after 6 wk. Glucose fluxes were calculated, and β-cell function was assessed by mathematical modeling. The incretin effect was calculated as the ratio of oral to iv insulin secretion. Intervention: We conducted a 6-wk, double-blind, randomized treatment with sitagliptin (100 mg/d; n = 25) or placebo (n = 22). Results: Relative to placebo, meal-induced changes in fasting glucose and glucose area under the curve (AUC) were greater with sitagliptin, in parallel with a lower appearance of oral glucose [difference (post-pre) AUC = −353 ± 915 vs. +146 ± 601 μmol · kg−1 · 5 h] and greater suppression of endogenous glucose production. Insulin sensitivity improved 10%, whereas total insulin secretion was unchanged. During the meal, β-cell glucose sensitivity improved (+19[29] vs. 5[21] pmol · min−1 · m−2 · mm−1; median [interquartile range]) and glucagon AUC decreased (19.6 ± 7.5 to 17.3 ± 7.1 ng · ml−1 · 5 h), whereas intact glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 AUC increased with sitagliptin vs. placebo. The incretin effect was unchanged because sitagliptin increased β-cell glucose sensitivity also during the isoglycemic test. Conclusions: Chronic sitagliptin treatment improves glycemic control by lowering the appearance of oral glucose, postprandial endogenous glucose release, and glucagon response, and by improving insulin sensitivity and β-cell glucose sensing in response to both oral and iv glucose.

Effect of Glucagon on Nocturnal Rates of Endogenous Glucose Production in Type 2 Diabetes

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 44-OR
Author(s):  
ANANDA BASU ◽  
HUALING ZHAI ◽  
RICKEY CARTER ◽  
RITA BASU
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Production ◽  
Endogenous Glucose Production ◽  
Endogenous Glucose

Impaired suppression of endogenous glucose production in lean Japanese patients with type 2 diabetes mellitus

2011 ◽  
Vol 93 (1) ◽  
pp. e1-e2 ◽  
Author(s):  
Mitsuyoshi Takahara ◽  
Hideaki Kaneto ◽  
Naoto Katakami ◽  
Taka-aki Matsuoka ◽  
Munehide Matsuhisa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glucose Production ◽  
Japanese Patients ◽  
Endogenous Glucose Production ◽  
Endogenous Glucose

Resistance training enhances insulin suppression of endogenous glucose production in elderly women

2016 ◽  
Vol 120 (6) ◽  
pp. 633-639 ◽  
Author(s):  
Miikka-Juhani Honka ◽  
Marco Bucci ◽  
Jonathan Andersson ◽  
Ville Huovinen ◽  
Maria Angela Guzzardi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Resistance Training ◽  
Maternal Obesity ◽  
Elderly Women ◽  
Glucose Production ◽  
Endogenous Glucose Production ◽  
Training Intervention ◽  
Ectopic Fat ◽  
Endogenous Glucose

An altered prenatal environment during maternal obesity predisposes offspring to insulin resistance, obesity, and their consequent comorbidities, type 2 diabetes and cardiovascular disease. Telomere shortening and frailty are additional risk factors for these conditions. The aim of this study was to evaluate the effects of resistance training on hepatic metabolism and ectopic fat accumulation. Thirty-five frail elderly women, whose mothers' body mass index (BMI) was known, participated in a 4-mo resistance training program. Endogenous glucose production (EGP) and hepatic and visceral fat glucose uptake were measured during euglycemic hyperinsulinemia with [18F]fluorodeoxyglucose and positron emission tomography. Ectopic fat was measured using magnetic resonance spectroscopy and imaging. We found that the training intervention reduced EGP during insulin stimulation [from 5.4 (interquartile range 3.0, 7.0) to 3.9 (−0.4, 6.1) μmol·kg body wt−1·min−1, P = 0.042] in the whole study group. Importantly, the reduction was higher among those whose EGP was more insulin resistant at baseline (higher than the median) [−5.6 (7.1) vs. 0.1 (5.4) μmol·kg body wt−1·min−1, P = 0.015]. Furthermore, the decrease in EGP was associated with telomere elongation ( r = −0.620, P = 0.001). The resistance training intervention did not change either hepatic or visceral fat glucose uptake or the amounts of ectopic fat. Maternal obesity did not influence the studied measures. In conclusion, resistance training improves suppression of EGP in elderly women. The finding of improved insulin sensitivity of EGP with associated telomere lengthening implies that elderly women can reduce their risk for type 2 diabetes and cardiovascular disease with resistance training.

Indomethacin Does Not Affect Endogenous Glucose Production in Type 2 Diabetes Mellitus

2001 ◽  
Vol 33 (11) ◽  
pp. 659-663 ◽  
Author(s):  
A. M. Pereira Arias ◽  
P. H. Bisschop ◽  
M. T. Ackermans ◽  
E. Endert ◽  
J. A. Romijn ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glucose Production ◽  
Endogenous Glucose Production ◽  
Endogenous Glucose

scholarly journals Regulation of endogenous glucose production after a mixed meal in type 2 diabetes

2002 ◽  
Vol 283 (2) ◽  
pp. E275-E283 ◽  
Author(s):  
Parag Singhal ◽  
Andrea Caumo ◽  
Peter E. Carey ◽  
Claudio Cobelli ◽  
Roy Taylor
Keyword(s):  
Type 2 Diabetes ◽  
Time Course ◽  
Glucose Production ◽  
Endogenous Glucose Production ◽  
Diabetic Group ◽  
Mixed Meal ◽  
Glucose Ingestion ◽  
Plasma Insulin Levels ◽  
Endogenous Glucose

The extent and time course of suppression of endogenous glucose production (EGP) in type 2 diabetes after a mixed meal have been determined using a new tracer methodology. Groups of age-, sex-, and weight-matched normal controls ( n = 8) and diet-controlled type 2 diabetic subjects ( n = 8) were studied after ingesting a standard mixed meal (550 kcal; 67% carbohydrate, 19% fat, 14% protein). There was an early insulin increment in both groups such that, by 20 min, plasma insulin levels were 266 ± 54 and 190 ± 53 pmol/l, respectively. EGP was similar basally [2.55 ± 0.12 mg · kg−1 · min−1 in control subjects vs. 2.92 ± 0.16 mg · kg−1 · min−1 in the patients ( P = 0.09)]. After glucose ingestion, EGP declined rapidly in both groups to ∼50% of basal within 30 min of the meal. Despite the initial rapid decrease, the EGP was significantly greater in the diabetic group at 60 min (1.75 ± 0.12 vs. 1.05 ± 0.14 mg · kg−1 · min−1; P < 0.01) and did not reach nadir until 210 min (0.96 ± 0.17 mg · kg−1 · min−1). Between 60 and 240 min, EGP was 47% higher in the diabetic group (0.89 ± 0.09 vs. 1.31 ± 0.13 mg · kg−1 · min−1, P < 0.02). These data quantitate the initial rapid suppression of EGP after a mixed meal in type 2 diabetes and the contribution of continuing excess glucose production to subsequent hyperglycemia.

1799-P: Lipotoxicity Impairs Central Regulation of Endogenous Glucose Production (EGP) in Type 2 Diabetes (T2D)

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1799-P
Author(s):  
SANDRA ALEKSIC ◽  
KEHAO ZHANG ◽  
ERIC LONTCHI YIMAGOU ◽  
SHIKSHA SHARMA ◽  
NORICA TOMUTA ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Production ◽  
Endogenous Glucose Production ◽  
Central Regulation ◽  
Endogenous Glucose
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