Splanchnic tissues play a crucial role in uremic glucose intolerance.
OBJECTIVE
Determine the mechanism of glucose intolerance in chronically uremic subjects.


METHODS
Comparison of doubly labeled oral glucose tolerance tests.


METHODS
Seven nondialyzed chronically uremic subjects (creatinine, 420 +/- 104 micromol/L) and 7 healthy subjects, matched for age and body mass index.


METHODS
Plasma glucose was labeled by an infusion of dideuterated glucose started 120 minutes before ingestion of 1 g/kg of naturally 13C-enriched corn starch glucose. Glucose levels and oxidation were monitored for 330 minutes after glucose ingestion.


RESULTS
Uremic subjects had normal fasting plasma glucose levels and impaired glucose tolerance with high plasma insulin (P <.001 versus controls). Glucose tolerance was impaired because of an increased total rate of appearance of glucose (cumulated on 330 minutes: uremic, 1,231 +/- 42 mg/kg/330 min, controls, 1,031 +/- 64; P <.05). Peripheral glucose uptake was increased (P <.05) because of an increased nonoxidative disposal (P =.051).


CONCLUSIONS
Although peripheral glucose uptake resisted the stimulatory effect of the high insulin levels, glucose tolerance was impaired through splanchnic metabolic disturbances: reduced splanchnic glucose uptake and increased endogenous glucose production. The respective contribution of these abnormalities remains to be determined.
Rigalleau
Vincent
V
Service de Nutrition et Diabétologie, USN, Hôpital Haut-Lévêque, Pessac, France.
Baillet
Laurence
L
Lasseur
Catherine
C
Moreau
Karine
K
Chauveau
Philippe
P
Aparicio
Michel
M
Normand
Sylvie
S
Desage
Michel
M
Laville
Martine
M
Deleris
Gérard
G
Combe
Christian
C
Gin
Henri
H
D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D003903:Deuterium; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism*; D018149:Glucose Intolerance / Q000209:etiology; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction; D014511:Uremia / Q000097:blood / Q000150:complications / Q000378:metabolism*; D014781:Viscera / Q000378:metabolism*
D001786:Blood Glucose; D007328:Insulin; D003903:Deuterium; D005947:Glucose