Correction of fasting hyperglycaemia with insulin or sulphonylurea lowers fasting ketone levels, but does not alter resting or post-glucose energy expenditure in non insulin dependent diabetes. Differences between the OGTT and the glucose clamp.
Sixteen non-obese non insulin dependent diabetic patients had a 75 g oral glucose tolerance test with simultaneous measurement of intermediary metabolites and of overall energy expenditure by indirect calorimetry during the test. The same patients had a 3H3 glucose infusion and hyperinsulinaemic glucose clamp procedure with glucose held at 10.0 mmol/l and insulin infused at 40 mU/m2/min. The changes in glucose and fat metabolism, in total energy balance and the fall in RQ during the glucose tolerance test did not correlate with the measures of hepatic glucose output or peripheral insulin resistance in these patients. Although the concept of insulin resistance is useful in considering the non insulin dependent diabetic state, the data derived from the body responses to a single glucose load are more relevant to the day to day fluctuation of the internal environment.
Boyd
K
K
Sir George E. Clark Metabolic Unit, Royal Victoria Hospital, Belfast, UK.
Boreham
C
C
Andrews
W J
WJ
Hadden
D R
DR
D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D004734:Energy Metabolism / Q000187:drug effects*; D005215:Fasting; D005260:Female; D005947:Glucose / Q000378:metabolism; D015309:Glucose Clamp Technique; D005951:Glucose Tolerance Test; D005905:Glyburide / Q000627:therapeutic use*; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy*; D007328:Insulin / Q000627:therapeutic use*; D007657:Ketone Bodies / Q000097:blood*; D008099:Liver / Q000378:metabolism; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D007657:Ketone Bodies; D005947:Glucose; D005905:Glyburide