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Regulation of endogenous glucose production after a mixed meal in type 2 diabetes

Lookup NU author(s): Dr Paraq Singhal, Dr Peter Carey, Professor Roy Taylor


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The extent and time course of suppression of endogenous glucose production (EGP) in type 2 diabetes after a mixed meal have been determined using a new tracer methodology. Groups of age-, sex-, and weight-matched normal controls (n = 8) and diet-controlled type 2 diabetic subjects (n = 8) were studied after ingesting a standard mixed meal (550 kcal; 67% carbohydrate, 19% fat, 14% protein). There was an early insulin increment in both groups such that, by 20 min, plasma insulin levels were 266 ± 54 and 190 ± 53 pmol/l, respectively. EGP was similar basally [2.55 ± 0.12 mg·kg-1· min-1 in control subjects vs. 2.92 ± 0.16 mg·kg-1·min-1 in the patients (P = 0.09)]. After glucose ingestion, EGP declined rapidly in both groups to ∼ 50% of basal within 30 min of the meal. Despite the initial rapid decrease, the EGP was significantly greater in the diabetic group at 60 min (1.75 ± 0.12 vs. 1.05 ± 0.14 mg·kg-1·min-1; P < 0.01) and did not reach nadir until 210 min (0.96 ± 0.17 mg·kg-1·min-1). Between 60 and 240 min, EGP was 47% higher in the diabetic group (0.89 ± 0.09 vs. 1.31 ± 0.13 mg·kg-1·min-1, P < 0.02). These data quantitate the initial rapid suppression of EGP after a mixed meal in type 2 diabetes and the contribution of continuing excess glucose production to subsequent hyperglycemia.

Publication metadata

Author(s): Singhal P, Caumo A, Carey PE, Cobelli C, Taylor R

Publication type: Article

Publication status: Published

Journal: American Journal of Physiology - Endocrinology and Metabolism

Year: 2002

Volume: 283

Issue: 2

Pages: E275-E283

Print publication date: 01/01/2002

ISSN (print): 0193-1849

ISSN (electronic): 1522-1555

Publisher: American Physiological Society

PubMed id: 12110532