Inappropriate glucagon response after oral compared with isoglycemic intravenous glucose administration in patients with type 1 diabetes
| العنوان: | Inappropriate glucagon response after oral compared with isoglycemic intravenous glucose administration in patients with type 1 diabetes |
|---|---|
| المؤلفون: | Tina Vilsbøll, Filip K. Knop, Jens J. Holst, Kristine J. Hare |
| المصدر: | American Journal of Physiology-Endocrinology and Metabolism. 298:E832-E837 |
| بيانات النشر: | American Physiological Society, 2010. |
| سنة النشر: | 2010 |
| مصطلحات موضوعية: | Adult, Blood Glucose, Male, medicine.medical_specialty, Physiology, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Glucagon-Like Peptides, Gastric Inhibitory Polypeptide, Type 2 diabetes, Glucagon, Young Adult, Physiology (medical), Internal medicine, Diabetes mellitus, medicine, Humans, Infusions, Intravenous, Type 1 diabetes, Glucose tolerance test, C-Peptide, medicine.diagnostic_test, business.industry, Insulin, Glucose Tolerance Test, medicine.disease, Glucagon-like peptide-1, Diabetes Mellitus, Type 1, Glucose, Endocrinology, Female, business, Hyperglucagonemia |
| الوصف: | Hyperglucagonemia following oral glucose ingestion in patients with type 1 diabetes (and type 2 diabetes) has been claimed to result from impaired intraislet insulin inhibition of glucagon. We looked at plasma glucagon responses to the oral glucose tolerance test (OGTT) and isoglycemic intravenous glucose infusion (IIGI) in patients with type 1 diabetes. Nine patients without residual β-cell function [age: 25 ± 9 yr; body mass index (BMI): 24 ± 2 kg/m2; fasting plasma glucose (FPG): 9.5 ± 2.1 mM; Hb A1c: 8.4 ± 1.2% (mean ± SD)] and eight healthy subjects (age: 28 ± 5 yr; BMI: 24 ± 3 kg/m2; FPG: 5.3 ± 0.2 mM; Hb A1c: 5.0 ± 0.1%) were examined on two separate occasions: 4-h 50-g OGTT and IIGI. Isoglycemia during IIGIs was obtained using 53 ± 5 g of glucose in patients with type 1 diabetes and 30 ± 3 g in control subjects ( P < 0.001), resulting in gastrointestinal-mediated glucose disposal [100% × (glucoseOGTT − glucoseIIGI/glucoseOGTT)] of −6 ± 9 and 40 ± 6% ( P < 0.01), respectively. Equal glucagon suppression during the two glucose stimuli was observed in healthy subjects, whereas patients with type 1 diabetes exhibited less inhibition in response to OGTT compared with IIGI (AUC: 1,519 ± 129 vs. 1,240 ± 86 pM·4 h; P = 0.03). This difference was even more pronounced during the initial 40 min with paradoxical hypersecretion of glucagon during OGTT and suppression during IIGI (AUC: 37 ± 13 vs. −33 ± 16 pM·40 min; P = 0.02). These results suggest that the inappropriate glucagon response to glucose in patients with type 1 diabetes occurs as a consequence of the oral administration way, suggesting a role of the gastrointestinal tract, possibly via glucagonotropic signaling from gut hormones (e.g., glucose-dependent insulinotropic polypeptide), in type 1 diabetic hyperglucagonemia. |
| تدمد: | 1522-1555 0193-1849 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bb5aff7a1e287a9f41fdfbaf75127f96Test https://doi.org/10.1152/ajpendo.00700.2009Test |
| رقم الانضمام: | edsair.doi.dedup.....bb5aff7a1e287a9f41fdfbaf75127f96 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15221555 01931849 |
|---|