title: Higher Endogenous Glucose Production During OGTT vs Isoglycemic Intravenous Glucose Infusion.
abstract: Oral glucose ingestion elicits a larger insulin response and delayed suppression of glucagon compared to isoglycemic IV glucose infusion (IIGI).
  
  
  
  We studied whether these differences translate into effects on endogenous glucose production (EGP) and glucose disposal in patients with type 2 diabetes and nondiabetic control subjects.
  
  
  
  This was a single-blinded, randomized, crossover study.
  
  
  
  The study was conducted at a specialized research unit.
  
  
  
  Ten patients with type 2 diabetes (age, [mean ± SD] 57.1 ± 6.7 years; body mass index, 29.0 ± 4.3 kg/m2; hemoglobin A1c, 53.8 ± 11.0 mmol/mol; duration of diabetes, 9.2 ± 5.0 years) and 10 matched nondiabetic control subjects (age, 56.0±10.7 years; body mass index, 29.8 ± 2.9 kg/m2; hemoglobin A1c, 33.8 ± 5.5 mmol/mol) participated.
  
  
  
  Three experimental days: 75 g-oral glucose tolerance test (OGTT), IIGI, and IIGI+glucagon (IIGI with a concomitant IV glucagon infusion [0.8 ng/kg/min from 0 to 25 minutes] designed to mimic portal glucagon concentrations during OGTT in the type 2 diabetic group) were undertaken.
  
  
  
  Glucose kinetics were assessed by tracer methodology.
  
  
  
  Glucose rate of disappearance was higher during the OGTT vs IIGI in the control group, but similar on all days in the diabetic group. Surprisingly, in both groups, EGP was more suppressed during IIGI than during OGTT, and exogenous glucagon infusion during IIGI did not restore EGP to the levels observed during OGTT.
  
  
  
  EGP was less suppressed during OGTT than during IIGI in both patients with type 2 diabetes and in nondiabetic control subjects. Based on the present experimental design, it was not possible to attribute this difference to the delayed glucagon suppression observed in the initial phase of the OGTT.
authors.affiliation: Center for Diabetes Research (A.L., J.I.B., M.C., M.G., T.V., F.K.K.), Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; The NNF Center for Basic Metabolic Research (A.L., J.J.H., F.K.K.), Copenhagen, Denmark; Department of Clinical Medicine (T.V., F.K.K.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Pharmacology (M.C.), Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Biomedical Sciences (G.v.H., J.J.H.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; and Department of Clinical Biochemistry (G.v.H.), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Asger
authors.initials: A
authors.lastname: Lund
authors.affiliation: Center for Diabetes Research (A.L., J.I.B., M.C., M.G., T.V., F.K.K.), Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; The NNF Center for Basic Metabolic Research (A.L., J.J.H., F.K.K.), Copenhagen, Denmark; Department of Clinical Medicine (T.V., F.K.K.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Pharmacology (M.C.), Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Biomedical Sciences (G.v.H., J.J.H.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; and Department of Clinical Biochemistry (G.v.H.), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jonatan I
authors.initials: JI
authors.lastname: Bagger
authors.affiliation: Center for Diabetes Research (A.L., J.I.B., M.C., M.G., T.V., F.K.K.), Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; The NNF Center for Basic Metabolic Research (A.L., J.J.H., F.K.K.), Copenhagen, Denmark; Department of Clinical Medicine (T.V., F.K.K.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Pharmacology (M.C.), Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Biomedical Sciences (G.v.H., J.J.H.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; and Department of Clinical Biochemistry (G.v.H.), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Mikkel
authors.initials: M
authors.lastname: Christensen
authors.affiliation: Center for Diabetes Research (A.L., J.I.B., M.C., M.G., T.V., F.K.K.), Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; The NNF Center for Basic Metabolic Research (A.L., J.J.H., F.K.K.), Copenhagen, Denmark; Department of Clinical Medicine (T.V., F.K.K.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Pharmacology (M.C.), Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Biomedical Sciences (G.v.H., J.J.H.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; and Department of Clinical Biochemistry (G.v.H.), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Magnus
authors.initials: M
authors.lastname: Grøndahl
authors.affiliation: Center for Diabetes Research (A.L., J.I.B., M.C., M.G., T.V., F.K.K.), Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; The NNF Center for Basic Metabolic Research (A.L., J.J.H., F.K.K.), Copenhagen, Denmark; Department of Clinical Medicine (T.V., F.K.K.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Pharmacology (M.C.), Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Biomedical Sciences (G.v.H., J.J.H.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; and Department of Clinical Biochemistry (G.v.H.), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Gerrit
authors.initials: G
authors.lastname: van Hall
authors.affiliation: Center for Diabetes Research (A.L., J.I.B., M.C., M.G., T.V., F.K.K.), Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; The NNF Center for Basic Metabolic Research (A.L., J.J.H., F.K.K.), Copenhagen, Denmark; Department of Clinical Medicine (T.V., F.K.K.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Pharmacology (M.C.), Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Biomedical Sciences (G.v.H., J.J.H.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; and Department of Clinical Biochemistry (G.v.H.), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jens J
authors.initials: JJ
authors.lastname: Holst
authors.affiliation: Center for Diabetes Research (A.L., J.I.B., M.C., M.G., T.V., F.K.K.), Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; The NNF Center for Basic Metabolic Research (A.L., J.J.H., F.K.K.), Copenhagen, Denmark; Department of Clinical Medicine (T.V., F.K.K.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Pharmacology (M.C.), Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Biomedical Sciences (G.v.H., J.J.H.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; and Department of Clinical Biochemistry (G.v.H.), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Tina
authors.initials: T
authors.lastname: Vilsbøll
authors.affiliation: Center for Diabetes Research (A.L., J.I.B., M.C., M.G., T.V., F.K.K.), Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; The NNF Center for Basic Metabolic Research (A.L., J.J.H., F.K.K.), Copenhagen, Denmark; Department of Clinical Medicine (T.V., F.K.K.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Pharmacology (M.C.), Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Biomedical Sciences (G.v.H., J.J.H.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; and Department of Clinical Biochemistry (G.v.H.), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Filip K
authors.initials: FK
authors.lastname: Knop
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D005934:Glucagon / Q000008:administration & dosage / Q000378:metabolism*; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D016037:Single-Blind Method
chemical_list: D001786:Blood Glucose; D005934:Glucagon; D005947:Glucose