Clinical correlates of basal hepatic glucose output and metabolic clearance rate of glucose using glucose-C-peptide-body mass indexes in ambulatory type 2 diabetic patients.
The use of glucose (G)--C-peptide (C)--body mass indexes (BMI) as clinical determinants of likely response to oral sulphonylurea agents in type 2 diabetic patients have been suggested by some investigators. The relationships between these clinical parameters are usually expressed as scores (C/G, G/BMI and C/BMI scores). Based on this approach, we have determined the significance of these clinical scores using isotopically-derived basal glucose fluxes (D[3-3H]glucose technique) in 26 subjects (10 type 2 diabetics and 16 nondiabetics) with a broad range (72-346 mg/dl) of fasting serum glucose (FSG) and BMI (19-39 kg/m2). The basal hepatic glucose output (HGO) correlated positively with FSG, BMI and G/BMI score and negatively with C/G score in the diabetic patients. We found no significant relationships between basal HGO and most of these parameters except FSG and G/BMI in the normal subjects. The basal metabolic clearance rate of glucose (MCR) significantly correlated, but inversely, with FSG and G/BMI score, but not with the C/G score or BMI in the diabetic patients. In the normal subjects, MCR significantly, but negatively, correlated with the BMI, but not with FSG, C/G or G/BMI scores. Neither basal HGO nor MCR correlated with fasting serum C-peptide, duration of diabetes or daily insulin dose. As a group, the basal HGO correlated positively with FSG, BMI and G/BMI scores but negatively with C/G Score. However, the basal MCR correlated negatively with FSG, BMI and G/BMI scores but positively with C/G score. In summary, the present cross-sectional study provides additional information on the determinants of fasting serum glucose levels in type 2 diabetic patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Osei
K
K
Department of Medicine, Ohio State University Hospitals, Columbus.
Holland
G C
GC
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D001835:Body Weight; D002096:C-Peptide / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008099:Liver / Q000378:metabolism*; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D012016:Reference Values
D001786:Blood Glucose; D002096:C-Peptide; D005947:Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents