Increased basal glucose production and utilization in nondiabetic first-degree relatives of patients with NIDDM.
To characterize the abnormalities in basal glucose homeostasis in people who are at increased risk for non-insulin-dependent diabetes mellitus (NIDDM), we measured the rates of basal hepatic glucose output (HGO), glucose disappearance, and metabolic clearance of glucose (MCR) in 27 nondiabetic first-degree relatives of NIDDM patients and 16 age-, sex-, and weight-matched healthy control subjects with no family history of NIDDM. Mean fasting plasma glucose was significantly lower (P less than 0.05) in control subjects (mean +/- SE 77 +/- 2 mg/dl) than in relatives (84 +/- 2 mg/dl). Mean basal insulin levels were not significantly different between relatives and control subjects (10.0 +/- 1.5 vs. 7.7 +/- 1.0 microU/ml). Mean basal HGO was significantly lower in control subjects compared with relatives (1.83 +/- 0.07 vs. 2.20 +/- 0.10 mg.kg-1.min-1, P less than 0.05). Mean MCR was similar in relatives (2.58 +/- 0.12 mg.kg-1.min-1) and control subjects (2.35 +/- 0.09 mg.kg-1.min-1). In summary, this study demonstrates that basal hepatic glucose production and glucose utilization are increased in glucose-tolerant first-degree relatives compared with healthy control subjects. We conclude that impaired basal hepatic glucose regulation rather than glucose disposal is present as an early defect in glucose-tolerant first-degree relatives of NIDDM patients.
Department of Internal Medicine, Ohio State University Hospitals, Columbus.
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Osei
D000328:Adult; D001481:Basal Metabolism; D002096:C-Peptide / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000235:genetics / Q000378:metabolism*; D005190:Family; D005192:Family Health; D005260:Female; D005947:Glucose / Q000378:metabolism* / Q000493:pharmacokinetics; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000378:metabolism; D008099:Liver / Q000378:metabolism; D008297:Male; D008657:Metabolic Clearance Rate
D002096:C-Peptide; D007328:Insulin; D005947:Glucose