Higher endogenous glucose production during OGTT vs isoglycemic intravenous glucose infusion
Abstract
Context: Oral glucose ingestion elicits a larger insulin response and delayed suppression of glucagon compared to isoglycemic IV glucose infusion (IIGI). Objective: 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. Design: This was a single-blinded, randomized, crossover study. Setting: The study was conducted at a specialized research unit. Participants: 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. Interventions: 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. Main Outcome Measures: Glucose kinetics were assessed by tracer methodology. Results: 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. Conclusion: 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.
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GLP-1 and GIP powerfully augment glucose-dependent insulin release in response to an enteral glucose load compared with an intravenous isoglycemic glucose load.
“However, they powerfully augment glucose-dependent insulin release in response to an enteral glucose load (in comparison to an intravenous isoglycemic glucose load) (10,11).”
From Gut mechanisms linking intestinal sweet sensing to glycemic control (2018) · cites this paper as [11]
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EJE PRIZE 2018: A gut feeling about glucagon
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“However, they powerfully augment glucose-dependent insulin release in response to an enteral glucose load (in comparison to an intravenous isoglycemic glucose load) (10, 11).”
Background
- Authors
- Lund, A., Bagger, J. I., Christensen, M., Grøndahl, M., van Hall, G., Holst, J. J., Vilsbøll, T., & Knop, F. K.
- Affiliations
- University of Copenhagen (DK)
- Department of Biomedical Sciences (G.v.H., J.J.H.), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;
- Corresponding author
- Knop, Filip K.
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2016-08-17
- Volume
- 101
- Issue
- 11
- Pages
- 4377-4384
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2512634675
- Cited by
- 12
- References
- 28
- Citations by year
- 2023: 1 · 2022: 3 · 2021: 4 · 2018: 4
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Novo Nordisk
- Novo Nordisk Fonden (NNF15OC0016230, NNF12OC1015904, NNF16OC0020224)
- Topics
- Health Sciences › Medicine › Surgery › 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
- endogenous glucose production, oral glucose tolerance test, type 2 diabetes, glucagon, glucose kinetics, glucose disposal, insulin response
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Type 2, Female, Glucagon, Glucose, Glucose Tolerance Test, Humans, Infusions, Intravenous, Male, Middle Aged, Outcome and Process Assessment, Health Care, Single-Blind Method, Cross-Over Studies
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