Forearm Glucose Uptake in Cirrhosis and Its Relationship to Glucose Tolerance

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Abstract
1. Oral glucose-tolerance tests (100 g) were carried out in six patients with stable well-compensated cryptogenic cirrhosis and in 12 control subjects. 2. In confirmation of previous studies, patients with cirrhosis had high post-glucose serum insulin levels and were glucose intolerant (mean incremental glucose area 954 ± 186 compared with 482 ± 35 mmol 3 h−11−1 in controls; P−11−1 of forearm in 3 h) were similar despite higher glucose levels and sustained high insulin levels in the cirrhotic patients. 4. Peak lactate concentrations after glucose were of similar magnitude in the two groups (0.66 ± 0.12 compared with 0.62 ± 0.75 mmol/l) but in the patients with cirrhosis the peak occurred later and was more sustained. 5. The glucose intolerance of cirrhosis is primarily due to impaired hepatic retention of the glucose load. Insulin resistance in peripheral tissues-5-also be important since the higher insulin concentrations found in cirrhotic patients failed to enhance peripheral glucose uptake.