Effect of Variations in Basal Plasma Glucose Concentration on Glucose Utilization (M) and Metabolic Clearance (MCR) Rates During Insulin Clamp Studies in Patients with Non-insulin-dependent Diabetes Mellitus

Diabetes ◽  
1982 ◽  
Vol 31 (5) ◽  
pp. 396-400 ◽  
Author(s):  
L. Doberne ◽  
M. S. Greenfield ◽  
M. Rosenthal ◽  
A. Widstrom ◽  
G. Reaven
1994 ◽  
Vol 15 (4) ◽  
pp. 137-148
Author(s):  
Leslie Plotnick

Insulin-dependent diabetes mellitus (IDDM) is a chronic, serious disease in children and adolescents. Its diagnosis is straightforward and rarely subtle. The major challenges of this disease for the child, family, and health-care team involve long-term management of medical and metabolic factors as well as psychological and behavioral concerns. While developments in the past 10 to 15 years have made metabolic control technically possible, psychological stresses and behavioral problems often interfere with metabolic goals. There are few, if any, other diseases that require such intensive and extensive self-care skills. Definitions Diabetes generally is classified in two types. Type I, or IDDM, is seen mostly in younger people (children and adolescents). It previously was called juvenile onset or ketosisprone. Insulin deficiency characterizes IDDM, and patients need exogenous insulin for survival. Type II, or non-IDDM (NIDDM), previously called adult or maturity onset, is the type seen most commonly in older people and in obesity and is not discussed in this review. To make a diagnosis of diabetes, a child must have either classic symptoms with a random plasma glucose above 200 mg/dL or specific plasma glucose levels before and after a standard glucose load if asymptomatic. The diagnosis of IDDM usually is clear-cut.


1994 ◽  
Vol 266 (3) ◽  
pp. R921-R928
Author(s):  
K. V. Axen ◽  
X. Li ◽  
K. Fung ◽  
A. Sclafani

A model of non-insulin-dependent diabetes mellitus (NIDDM) has been developed in adult rats by combining bilateral electrolytic lesions of the ventromedial hypothalamus (VMH) and high fat-high sucrose diets. VMH-dietary obese rats showed fasting hyperinsulinemia (> or = 540 pM) and hypertriglyceridemia (> or = 180 mg/dl) generally within 3 wk on the protocol. Fasting hyperglycemia (> or = 10 mM) was observed in the majority of animals in seven consecutive experiments. Hyperglycemic animals showed impaired glucose tolerance despite high prevailing insulin levels. Pancreatic islets isolated from VMH-dietary obese rats showed a loss of insulin secretory response to glucose by week 5, before the onset of hyperglycemia. Islets from hyperglycemic rats no longer responded to an increase in glucose concentration and failed to suppress insulin release normally in response to 15 nM norepinephrine or to a decrease in glucose concentration. This model mimics the major characteristics of obesity-associated human NIDDM as well as several stages of its progression, rendering it useful for studying the etiology of the metabolic and secretory defects in the syndrome.


1996 ◽  
Vol 81 (5) ◽  
pp. 2027-2033 ◽  
Author(s):  
Sheri R. Colberg ◽  
James M. Hagberg ◽  
Steve D. McCole ◽  
Joseph M. Zmuda ◽  
Paul D. Thompson ◽  
...  

Colberg, Sheri R., James M. Hagberg, Steve D. McCole, Joseph M. Zmuda, Paul D. Thompson, and David E. Kelley. Utilization of glycogen but not plasma glucose is reduced in individuals with NIDDM during mild-intensity exercise. J. Appl. Physiol. 81(4): 2027–2033, 1996.—To test the hypothesis that substrate utilization during mild-intensity exercise differs in non-insulin-dependent diabetes mellitus (NIDDM) compared with nondiabetic subjects, seven lean healthy subjects (L), seven obese healthy subjects (O), and seven individuals with NIDDM were studied during 40 min of mild-intensity cycling (40% of peak O2 uptake). Systemic utilization of plasma glucose (Glc Rd) was determined by using isotope dilution methods. Gas exchange was measured to determine rates of carbohydrate (CHO) and lipid oxidation. During exercise, when CHO oxidation was greater than Glc Rd, the net oxidation of glycogen was calculated as the difference: CHO oxidation − Glc Rd. During mild-intensity cycling, the respiratory exchange ratio was similar across groups (0.87 ± 0.02, 0.85 ± 0.02, and 0.86 ± 0.01 in L, O, and NIDDM subjects, respectively), and CHO oxidation accounted for one-half of total energy expenditure during exercise. Glc Rd increased during exercise and was greatest in subjects with NIDDM (3.0 ± 0.2, 2.9 ± 0.2, and 4.5 ± 0.4 ml ⋅ kg−1 ⋅ min−1in L, O, and NIDDM subjects, respectively, P < 0.05), yet Glc Rd was less than CHO oxidation during exercise, indicating net oxidation of glycogen. Glycogen oxidation was greater in L and O than in NIDDM subjects (3.4 ± 1.0, 2.5 ± 0.9, and 1.7 ± 0.8 ml ⋅ kg−1 ⋅ min−1; P < 0.05). In summary, during mild-intensity exercise, NIDDM subjects have an increased Glc Rd and a decreased oxidation of muscle glycogen.


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