Increased renal glucose metabolism in Type 1 diabetes mellitus
| العنوان: | Increased renal glucose metabolism in Type 1 diabetes mellitus |
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| المؤلفون: | Christian Meyer, Michael Stumvoll, A. Tolias, D. Platanisiotis, L. Vlachos, Asimina Mitrakou |
| المصدر: | Diabetic Medicine. 22:453-459 |
| بيانات النشر: | Wiley, 2005. |
| سنة النشر: | 2005 |
| مصطلحات موضوعية: | Adult, Blood Glucose, Male, Glycosuria, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Glucose uptake, Kidney, Endocrinology, Diabetes mellitus, Internal medicine, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Insulin, Diabetic Nephropathies, Type 1 diabetes, business.industry, medicine.disease, Renal glucose reabsorption, Diabetes Mellitus, Type 1, medicine.anatomical_structure, Hyperglycemia, Renal blood flow, Female, medicine.symptom, business |
| الوصف: | AIMS In poorly controlled diabetes, increased renal glucose uptake has been implicated in the pathogenesis of diabetic nephropathy by promoting nonenzymatic glycosylation of proteins, activation of protein kinase C, and increased polyol pathway flux. However, whether glucose uptake by the diabetic kidney is actually increased, especially in patients with Type 1 diabetes, is unclear. METHODS To examine this question, we used a combination of net balance and isotopic techniques to compare renal glucose uptake in 12 subjects with Type 1 diabetes before and after restoration of near normoglycaemia by infusion of insulin with that in 15 postabsorptive nondiabetic volunteers. RESULTS Prior to insulin infusion, the diabetic subjects were markedly hyperglycaemic (arterial glucose 15.8 +/- 0.9 vs. 4.4 +/- 0.1 mm) and their renal tissue glucose uptake (i.e. total glucose disappearance across the kidney minus glycosuria) was increased more than 2 1/2-fold (388 +/- 43 vs. 148 +/- 12 micromol/min, P < 0.001). This was wholly explained by the mass action effects of hyperglycaemia since the diabetic subjects had normal renal blood flow (1575 +/- 82 vs. 1492 +/- 68 mL/min, P = 0.46) and reduced renal tissue glucose fractional extraction (1.7 +/- 0.2 vs. 2.3 +/- 0.1%, P = 0.027). Insulin infusion for three hours, which restored near normoglycaemia (arterial glucose 7.6 +/- 0.7 mm), reduced renal tissue glucose uptake toward normal (258 +/- 41 micromol/min, P = 0.006) without altering renal blood flow (1557 +/- 110, P = 0.63) or renal tissue glucose fractional extraction (2.1 +/- 0.3%, P = 0.35). Renal and hepatic glucose release, which had been increased (419 +/- 49 and 960 +/- 54 vs. 204 +/- 9 and 734 +/- 32 micromol/min, both P < 0.001), were suppressed by insulin to 138 +/- 22 and 520 +/- 53 micromol/min, respectively (both P < 0.001). CONCLUSIONS In poorly controlled Type 1 diabetes, renal glucose uptake is markedly increased, which provides a link between hyperglycaemia and biochemical processes implicated in the pathogenesis of diabetic nephropathy. Its reversal by restoration of near normoglycaemia with insulin may explain the benefit of intensive insulin therapy in preventing diabetic nephropathy. |
| تدمد: | 1464-5491 0742-3071 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f1a6ba24625b8e804618bcadfafd01d7Test https://doi.org/10.1111/j.1464-5491.2005.01440.xTest |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....f1a6ba24625b8e804618bcadfafd01d7 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14645491 07423071 |
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