Enteral infusion of glucose at rates approximating EGP enhances glucose disposal but does not cause hypoglycemia

Farhad Zangeneh, Rita Basu, Pankaj Shah, Puneet Arora, Michael Camilleri, Robert A. Rizza

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalAmerican Journal of Physiology - Endocrinology and Metabolism
Volume285
Issue number2 48-2
StatePublished - Aug 1 2003

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Hypoglycemia
Small Intestine
Glucose
Insulin
Glucose sensors
Healthy Volunteers
Chemical activation

Keywords

  • Endogenous glucose production
  • Glucose uptake
  • Portal signal
  • Splanchnic glucose extraction

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology
  • Physiology

Cite this

Enteral infusion of glucose at rates approximating EGP enhances glucose disposal but does not cause hypoglycemia. / Zangeneh, Farhad; Basu, Rita; Shah, Pankaj; Arora, Puneet; Camilleri, Michael; Rizza, Robert A.

In: American Journal of Physiology - Endocrinology and Metabolism, Vol. 285, No. 2 48-2, 01.08.2003.

Research output: Contribution to journalArticle

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abstract = "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.",
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AU - Shah, Pankaj

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AU - Camilleri, Michael

AU - Rizza, Robert A.

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