High blood ketone body concentration in type 2 non-insulin dependent diabetic patients.
To assess the metabolic disturbances, and, in particular, the occurrence of high blood ketone body concentration in post-absorptive Type 2 (non-insulin-dependent) diabetic patients as compared to a matched normal population, a study was carried out in a group of 78 Type 2 diabetic outpatients matched for age and sex and in 78 normal individuals. In all subjects we measured HbA1c, and fasting levels of glucose, FFA, lactate, pyruvate, glycerol, alanine, 3-hydroxybutyrate, acetoacetate, uric acid, total cholesterol, triglycerides, creatinine, growth hormone, cortisol, glucagon, free insulin, and C-peptide. Multistix strips were used for urine ketone determination. As expected HbA1c, and plasma glucose were higher in Type 2 diabetics. This was associated with multiple metabolic disturbances as shown by higher circulating concentrations of FFA, glycerol and gluconeogenic precursors. Similarly, blood levels of ketones (351 +/- 29 vs 159 +/- 15 umol/l; P < 0.0001) were increased, in spite of higher plasma free-insulin (77 +/- 7 vs. 49 +/- 14 pmol/l; p < 0.0001) and C-peptide concentration (0.63 +/- 0.03 vs. 0.46 +/- 0.07 nmol/l; P < 0.05) and no differences in plasma levels of cortisol, and growth hormone. Plasma glucagon levels were higher in Type 2 diabetics. Blood ketone body levels were directly correlated with both plasma glucose and FFA concentrations. These observations clearly show that Type 2 diabetes is a pathologic condition characterised by multiple metabolic disturbances which are fully apparent in the basal state. Furthermore, we emphasise that Type 2 diabetic patients, though not insulin deficient, may present a significant increase in their fasting levels of ketone bodies.
Avogaro
A
A
Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Padova, Azienda Ospedaliera di Padova, Italy.
Crepaldi
C
C
Miola
M
M
Maran
A
A
Pengo
V
V
Tiengo
A
A
Del Prato
S
S
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005215:Fasting; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007657:Ketone Bodies / Q000097:blood*; D008297:Male
D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D007657:Ketone Bodies