Cited by 917Pancreatic function and diabetesDiabetes Treatment and ManagementDiabetes Management and Research

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Plasma Insulin Responses to Oral and Intravenous Glucose: Studies in Normal and Diabetic Subjects*

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Perley, Michael J., Kipnis, David M.·1967·Journal of Clinical Investigation

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Abstract

The plasma insulin responses of normal weight and obese, diabetic, and nondiabetic subjects to intravenous glucose was only 30-40% of that seen after oral glucose, indicating that alimentary mechanism(s) in addition to the arterial blood sugar concentration regulate insulin secretion. Observations made in subjects with diverted portal circulation indicate that the alimentary insulinogenic mechanism is located in the intestinal tract. The insulinogenic potency of the alimentary and glycemic stimuli expressed in terms of insulin secretion per gram of glucose were remarkably similar within each group of individuals. Between these groups, however, there were considerable differences. Obesity, with or without associated diabetes, was associated with a true hypersecretory responsiveness, whereas diabetes was characterized, with or without obesity, by a marked impairment in insulin secretion. The experimental design used in these studies permitted quantitation of the magnitude of the glycemic component of an oral glucose load. As a consequence of impaired insulin secretion, a greater than normal proportion of the oral glucose load escapes initial hepatic extraction in the maturity-onset diabetic and enters the peripheral circulation. Therefore, in the noninsulin-requiring maturity-onset diabetic, the glycemic insulinogenic stimulus for a given oral glucose load is significantly greater than in normal subjects and accounts for the excessive plasma insulin responses observed late in the course of an oral glucose tolerance test.

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DETERMINATION OF BLOOD SUGAR
Somogyi, M. (1945) · Journal of Biological Chemistry · doi:10.1016/s0021-9258(18)43098-0 · Cited by 1,788
Plasma Insulin Response to Oral and Intravenous Glucose Administration1
ELRICK, H., STIMMLER, L., HLAD, C. J., & ARAI, Y. (1964) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-24-10-1076 · Cited by 857
Insulin Secretion in Response to Glycemic Stimulus: Relation of Delayed Initial Release to Carbohydrate intolerance in Mild Diabetes Mellitus*
Seltzer, H. S., Allen, E. W., Herron, A. L., & Brennan, M. T. (1967) · Journal of Clinical Investigation · doi:10.1172/jci105534 · Cited by 819 · cited 1×
“(24) and Cerasi and Luft (25) that insulin secretion is impaired in diabetes mellitus.”
Background
New Interpretation of Oral Glucose Tolerance
Mcintyre, N., Holdsworth, C. D., & Turner, D. S. (1964) · The Lancet · doi:10.1016/s0140-6736(64)90011-x · Cited by 738
Promotion of Insulin Secretion by Glucagon
Samols, E., Marri, G., & Marks, V. (1965) · The Lancet · doi:10.1016/s0140-6736(65)90761-0 · Cited by 521
Intestinal Factors in the Control of Insulin Secretion
McIntyre, N., Holdsworth, C. D., & Turner, D. S. (1965) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-25-10-1317 · Cited by 382
THE PLASMA INSULIN RESPONSE TO GLUCOSE INFUSION IN HEALTHY SUBJECTS AND IN DIABETES MELLITUS
Cerasi, E., & Luft, R. (1967) · Acta Endocrinologica · doi:10.1530/acta.0.0550278 · Cited by 371
Plasma insulin responses to glucose and tolbutamide of normal weight and obese diabetic and nondiabetic subjects
Perley, M., & Kipnis, D. M. (1966) · Diabetes · doi:10.2337/diab.15.12.867 · Cited by 330
Self-citation
Plasma Insulin Concentrations in Nondiabetic and Early Diabetic Subjects: Determinations by a New Sensitive Immuno-assay Technic
Yalow, R. S., & Berson, S. A. (1960) · Diabetes · doi:10.2337/diab.9.4.254 · Cited by 330
PLASMA INSULIN AND GROWTH HORMONE LEVELS IN OBESITY AND DIABETES
Yalow, R. S., Glick, S. M., Roth, J., & Berson, S. A. (1965) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1965.tb34803.x · Cited by 199

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Authors: Perley, M. J., & Kipnis, D. M.
Affiliations: Washington University in St. Louis (US)
Venue: Journal of Clinical Investigation
Publisher: American Society for Clinical Investigation
Published: 1967-12-01
Volume: 46
Issue: 12
Pages: 1954-1962
ISSN: 0021-9738 (ISSN-L)
DOI: 10.1172/jci105685
PMC: PMC292948
OpenAlex: W2169558934
Cited by: 917
References: 24
Citations by year: 2026: 12 · 2025: 12 · 2024: 15 · 2023: 17 · 2022: 12 · 2021: 16 · 2020: 20 · 2019: 25 · 2018: 15 · 2017: 15 · 2016: 28 · 2015: 33 · 2014: 13 · 2013: 25 · 2012: 16
FWCI: 60.63
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Journal of Clinical Investigation (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords: insulin secretion, oral glucose tolerance, intravenous glucose, obesity, type 2 diabetes, hypersecretion, insulin resistance
MeSH terms: Adolescent, Adult, Aged, Arteries, Capillaries, Child, Diabetes Mellitus, Glucose, Humans, Infusions, Parenteral, Insulin, Middle Aged, Obesity, Veins

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Plasma Insulin Responses to Oral and Intravenous Glucose: Studies in Normal and Diabetic Subjects*

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