title: Splanchnic tissues play a crucial role in uremic glucose intolerance.
abstract: 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.
authors.affiliation: Service de Nutrition et Diabétologie, USN, Hôpital Haut-Lévêque, Pessac, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Rigalleau
authors.forename: Laurence
authors.initials: L
authors.lastname: Baillet
authors.forename: Catherine
authors.initials: C
authors.lastname: Lasseur
authors.forename: Karine
authors.initials: K
authors.lastname: Moreau
authors.forename: Philippe
authors.initials: P
authors.lastname: Chauveau
authors.forename: Michel
authors.initials: M
authors.lastname: Aparicio
authors.forename: Sylvie
authors.initials: S
authors.lastname: Normand
authors.forename: Michel
authors.initials: M
authors.lastname: Desage
authors.forename: Martine
authors.initials: M
authors.lastname: Laville
authors.forename: Gérard
authors.initials: G
authors.lastname: Deleris
authors.forename: Christian
authors.initials: C
authors.lastname: Combe
authors.forename: Henri
authors.initials: H
authors.lastname: Gin
mesh_terms: 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*
chemical_list: D001786:Blood Glucose; D007328:Insulin; D003903:Deuterium; D005947:Glucose