Defective insulin-mediated splanchnic glucose regulation and glucose clearance: early glucose homeostatic defects in nondiabetic, young offspring of patients with noninsulin-dependent diabetes mellitus.
Nondiabetic, young offspring of noninsulin-dependent diabetic (NIDDM) patients manifest insulin insensitivity. The pathophysiologic implications of the insulin insensitivity are uncertain since such subjects are usually normoglycemic. We have, therefore, studied isotopically the glucose turnover fluxes (D(3-3H) glucose technique) during postabsorptive state and after a physiological solid mixed meal ingestion for 240 min in 13 nondiabetic offspring and eight age-, sex- and weight-matched controls. Mean fasting serum glucose (84 +/- 3 vs. 78 +/- 2 mg/dl) and insulin (13.9 +/- 1.5 vs. 5.3 +/- 0.8 microU/ml) were significantly (p less than 0.05) greater in the offspring vs. controls. After the mixed meal ingestion, both serum glucose and insulin levels rose to significantly higher levels throughout the study period in the offspring vs. controls. Basal (2.04 +/- 0.73 vs. 1.84 +/- 0.76 ng/ml) and peak (5.72 +/- 0.65 vs. 6.47 +/- 0.40 ng/ml) serum c-peptide levels were not significantly different between the offspring and controls, respectively. Mean basal hepatic glucose output was significantly (p less than 0.05) higher in the offspring vs. controls (79 +/- 6 vs. 66 +/- 6 mg/m2.min). Following the mixed meal ingestion, the total splanchnic glucose appearance was significantly greater and qualitatively different in the offspring vs. controls. This occurred in the presence of identical intestinal carbohydrate absorption rates in both groups as assessed by simultaneous D-xylose test. Despite higher serum insulin levels, basal and post-meal metabolic clearance rates of glucose were similar in the two groups. We conclude that in nondiabetic offspring, greater basal and post-meal serum glucose and insulin levels occur.(ABSTRACT TRUNCATED AT 250 WORDS)
Osei
K
K
Department of Internal Medicine, Ohio State University Hospitals, Columbus.
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000235:genetics*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood*; D007408:Intestinal Absorption; D007700:Kinetics; D008099:Liver / Q000378:metabolism; D008297:Male; D013152:Splanchnic Circulation
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D005947:Glucose