TY - JOUR
T1 - Enteral infusion of glucose at rates approximating EGP enhances glucose disposal but does not cause hypoglycemia
AU - Zangeneh, Farhad
AU - Basu, Rita
AU - Shah, Pankaj
AU - Arora, Puneet
AU - Camilleri, Michael
AU - Rizza, Robert A.
PY - 2003/8/1
Y1 - 2003/8/1
N2 - Portal infusion of glucose at rates approximating endogenous glucose production (EGP) causes paradoxical hypoglycemia in wild-type but not GLUT2 null mice, implying activation of a specific portal glucose sensor. To determine whether this occurs in humans, glucose containing [3-3H]glucose was infused intraduodenally at rates of 3.1 mg·kg-1·min-1 (n = 5), 1.55 mg·kg-1·min-1 (n = 9), or 0/0.1 mg·kg-1·min-1 (n = 9) for 7 h in healthy nondiabetic subjects. [6,6-2H2] glucose was infused intravenously to enable simultaneous measurement of EGP, glucose disappearance, and the rate of appearance of the intraduodenally infused glucose. Plasma glucose concentrations fell (P < 0.01) from 90 ± 1 to 84 ± 2 mg/dl during the 0/0.1 mg·kg-1·min-1 id infusions but increased (P < 0.001) to 104 ± 5 and 107 ± 3 mg/dl, respectively, during the 1.55 and 3.1 mg·kg-1·min-1 id infusions. In contrast, insulin increased (P < 0.05) during the 1.55 and 3.0 mg·kg-1·min-1 infusions, reaching a peak of 10 ± 2 and 18 ± 5 μU/ml, respectively, by 2 h. Insulin concentrations then fell back to concentrations that no longer differed by study end (7 ± 1 vs. 8 ± 1 μU/ml). This resulted in comparable suppression of EGP by study end (0.84 ± 0.2 and 0.63 ± 0.1 mg·kg-1·. min-1). Glucose disappearance was higher (P < 0.01) during the final hour of the 3.1 than 1.55 mg·kg-1·min-1 id infusion (4.47 ± 0.2 vs. 2.6 ± 0.1 mg·kg-1·min-1), likely because of the slightly, but not significantly, higher glucose and insulin concentrations. We conclude that, in contrast to mice, selective portal glucose delivery at rates approximating EGP does not cause hypoglycemia in humans.
AB - Portal infusion of glucose at rates approximating endogenous glucose production (EGP) causes paradoxical hypoglycemia in wild-type but not GLUT2 null mice, implying activation of a specific portal glucose sensor. To determine whether this occurs in humans, glucose containing [3-3H]glucose was infused intraduodenally at rates of 3.1 mg·kg-1·min-1 (n = 5), 1.55 mg·kg-1·min-1 (n = 9), or 0/0.1 mg·kg-1·min-1 (n = 9) for 7 h in healthy nondiabetic subjects. [6,6-2H2] glucose was infused intravenously to enable simultaneous measurement of EGP, glucose disappearance, and the rate of appearance of the intraduodenally infused glucose. Plasma glucose concentrations fell (P < 0.01) from 90 ± 1 to 84 ± 2 mg/dl during the 0/0.1 mg·kg-1·min-1 id infusions but increased (P < 0.001) to 104 ± 5 and 107 ± 3 mg/dl, respectively, during the 1.55 and 3.1 mg·kg-1·min-1 id infusions. In contrast, insulin increased (P < 0.05) during the 1.55 and 3.0 mg·kg-1·min-1 infusions, reaching a peak of 10 ± 2 and 18 ± 5 μU/ml, respectively, by 2 h. Insulin concentrations then fell back to concentrations that no longer differed by study end (7 ± 1 vs. 8 ± 1 μU/ml). This resulted in comparable suppression of EGP by study end (0.84 ± 0.2 and 0.63 ± 0.1 mg·kg-1·. min-1). Glucose disappearance was higher (P < 0.01) during the final hour of the 3.1 than 1.55 mg·kg-1·min-1 id infusion (4.47 ± 0.2 vs. 2.6 ± 0.1 mg·kg-1·min-1), likely because of the slightly, but not significantly, higher glucose and insulin concentrations. We conclude that, in contrast to mice, selective portal glucose delivery at rates approximating EGP does not cause hypoglycemia in humans.
KW - Endogenous glucose production
KW - Glucose uptake
KW - Portal signal
KW - Splanchnic glucose extraction
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U2 - 10.1152/ajpendo.00055.2003
DO - 10.1152/ajpendo.00055.2003
M3 - Article
C2 - 12857674
AN - SCOPUS:0042804811
SN - 0193-1849
VL - 285
SP - E280-E286
JO - American Journal of Physiology - Endocrinology and Metabolism
JF - American Journal of Physiology - Endocrinology and Metabolism
IS - 2 48-2
ER -