Glucose Dynamics in Normal Subjects and Diabetic Patients before and after a Glucose Load

The method of successive measured injections of tracer using uniformly labeled C-14-glucose as tracer was applied to determine the pool size, apparent distribution space and the rates of endogenous glucose production and utilization in the fasting state and at twenty to 110 minutes after the intravenous injection of a 0.3 gm./kg. glucose load in six nondiabetic and sixteen diabetic subjects. The amount of intermixing glucose (“pool”) and the endogenous glucose production in the fasting state were higher in diabetics than in normals. The rate of glucose production decreased after the intravenous injection of the glucose in normals and nonketotic diabetics, but not in three out of four ketotic diabetics. The average rate of glucose utilization in the fasting state was found to be slightly higher in diabetics than in normals, but it increased to a lesser extent following the injection of glucose. This smaller increase and larger glucose pool are the main causes of decreased glucose tolerance in diabetics. The exponential slope of the concentration of glucose in the plasma after an intravenous injection of glucose (usually referred to as ‘K’) was not found to be correlated significantly with the rate of glucose utilization.

[1]  G. Hetenyi,et al.  Effect of High Blood Sugar Levels upon Splanchnic Sugar Output in Experimental Diabetes , 1960, Diabetes.

[2]  R. Steele,et al.  INHIBITION BY INSULIN OF HEPATIC GLUCOSE PRODUCTION IN THE NORMAL DOG. , 1965, The American journal of physiology.

[3]  J. Herrick,et al.  THE MECHANISM OF REGULATION OF THE BLOOD SUGAR BY THE LIVER , 1938 .

[4]  George A. Bray,et al.  A simple efficient liquid scintillator for counting aqueous solutions in a liquid scintillation counter , 1960 .

[5]  S. Weinhouse,et al.  Quantitative Estimation of the Cori Cycle in the Human , 1963 .

[6]  R. Bellens,et al.  INSULIN RESPONSE AND GLUCOSE-C14 DISAPPEARANCE RATE DURING THE GLUCOSE TOLERANCE TEST IN THE UNANESTHETIZED DOG. , 1963, Metabolism: clinical and experimental.

[7]  R. Steele,et al.  Does a glucose load inhibit hepatic sugar output? C14 glucose studies in eviscerated dogs. , 1959, The American journal of physiology.

[8]  F. Depocas.  GLUCOSE OXIDATION IN THE ALLOXAN-DIABETIC RAT. , 1964, The American journal of physiology.

[9]  S. Weinhouse,et al.  Effects of insulin on blood glucose entry and removal rates in normal dogs. , 1957, The Journal of biological chemistry.

[10]  R. Steele.  Use of C14-glucose to measure hepatic glucose production following an intravenous glucose load or after injection of insulin. , 1959, Metabolism: clinical and experimental.

[11]  G. Hetényi,et al.  Successive measured injections of tracer as a method for determining characteristics of accumulation and turnover in higher animals with access limited to blood: tests in hydrodynamic systems and initial observations on insulin action in dogs. , 1959, Metabolism: clinical and experimental.

[12]  W. Shreeve,et al.  Conversion of DL-lactate-2-C14 or -3-C14 or pyruvate-2-C14 to blood glucose in humans: effects of diabetes, insulin, tolbutamide, and glucose load. , 1963, Journal of Clinical Investigation.

[13]  S. Weinhouse,et al.  Turnover rates of blood glucose in normal dogs during hyperglycemia induced by glucose or glucagon. , 1958, The Journal of biological chemistry.

[14]  R. R. White,et al.  Glucose utilization in sheep. , 1961, The Biochemical journal.

[15]  E. Neufeld,et al.  CARBOHYDRATE METABOLISM. , 1965, Annual review of biochemistry.

[16]  A. Rappaport,et al.  Absolute Rates of Glucose Production, Accumulation, and Utilization in the Dog at Pancreatectomy and Thereafter , 1964, Diabetes.

[17]  J. D. Myers.  Net splanchnic glucose production in normal man and in various disease states. , 1950, The Journal of clinical investigation.

[18]  H. Himsworth.  THE MECHANISM OF DIABETES MELLITUS , 1939 .

[19]  S. Soskin,et al.  A RELATIONSHIP BETWEEN THE BLOOD SUGAR LEVEL AND THE RATE OF SUGAR UTILIZATION, AFFECTING THE THEORIES OF DIABETES , 1937 .

[20]  F. Depocas.  Turnover of plasma glucose in anesthetized warm- and cold-acclimated rats exposed to cold. , 1959, Canadian journal of biochemistry and physiology.

[21]  C J HLAD,et al.  Further studies of the kinetics of glucose utilization. I. A new method of data analysis. , 1959 .

[22]  E. Chain.  Recent Studies on Carbohydrate Metabolism* , 1959, Canadian Medical Association journal.

[23]  W. Shreeve,et al.  C14 studies in carbohydrate metabolism. II. The oxidation of glucose in diabetic human subjects. , 1956, Metabolism: clinical and experimental.

[24]  G. Searle,et al.  Plasma Glucose Turnover in Humans as Studied with C14 Glucose : Influence of Insulin and Tolbutamide , 1959, Diabetes.

[25]  G. Searle,et al.  Inhibitory action of hyperglycemia on delivery of glucose to the blood stream by liver of the normal dog. , 1952, The American journal of physiology.

[26]  P. Bondy,et al.  STUDIES OF THE ROLE OF THE LIVER IN HUMAN CARBOHYDRATE METABOLISM BY THE VENOUS CATHETER TECHNIC. I. NORMAL SUBJECTS UNDER FASTING CONDITIONS AND FOLLOWING THE INJECTION OF GLUCOSE. , 1949, The Journal of clinical investigation.

[27]  S. Weinhouse,et al.  Blood glucose replacement rates in normal and diabetic humans. , 1961, Journal of applied physiology.