Effect of Hyperglycemiaper seon Glucose Disposal and Clearance in Noninsulin-Dependent Diabetics*

Publisher Website
Google Scholar
Abstract
To determine the relationship between the plasma glucose level and the rate of glucose disposal in patients with noninsulin-dependent diabetes mellitus (NIDDM), the glucose disposal rate was measured by isotope dilution ([3-3H] glucose infusion) at two different glucose levels but at the same insulin level in seven patients with untreated NIDDM [fasting plasma glucose, 263 ± 26 (mean ± SEM)]. The infusion of somatostatin (500 μg/h) and insulin (30 mU/m2-min) produced fixed peripheral insulin levels of 61 ± 4 μU/ml. When the plasma glucose level was kept at 96 ± 2 mg/dl with a variable rate glucose infusion, the glucose disposal rate was 222 ± 13 mg/min, and the glucose clearance rate (glucose disposal rate ÷ plasma glucose level) was 232 ± 14 ml/min. Increasing the glucose level to 191 ± 4 mg/dl produced a significant rise (P < 0.001) in glucose disposal to 391 ± 32 mg/min, while glucose clearance fell significantly (P < 0.005) to 204 ± 13 ml/min. Thus, although the rise in the glucose level caused an increase in the glucose disposal rate, the relationship between the glucose level and the glucose disposal rate was not strictly proportional. Using a simplified model for total glucose disposal rate that includes both fixed (independent of glucose concentration) and proportional (dependent on glucose concentration) uptake, the fixed uptake component was calculated to be 52 ± 9 mg/min. This fixed amount of uptake may be due to saturation of the glucose transport system at a low glucose level in some tissues, notably the brain. We conclude that calculation of the glucose clearance rate to compare glucose disposal at differing glucose levels in NIDDM subjects will introduce an error that may affect the interpretation of the results. (J Clin Endocrinol Metab56: 819, 1983)

This publication has 1 reference indexed in Scilit: