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Diabetes Division, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78284
To investigate the effect
of elevated plasma free fatty acid (FFA) concentrations on splanchnic
glucose uptake (SGU), we measured SGU in nine healthy subjects (age,
44 ± 4 yr; body mass index, 27.4 ± 1.2 kg/m2;
fasting plasma glucose, 5.2 ± 0.1 mmol/l) during an
Intralipid-heparin (LIP) infusion and during a saline (Sal)
infusion. SGU was estimated by the oral glucose load
(OGL)-insulin clamp method: subjects received a 7-h euglycemic insulin
(100 mU · m
2 · min
1) clamp,
and a 75-g OGL was ingested 3 h after the insulin clamp was
started. After glucose ingestion, the steady-state glucose infusion
rate (GIR) during the insulin clamp was decreased to maintain
euglycemia. SGU was calculated by subtracting the integrated decrease
in GIR during the period after glucose ingestion from the ingested
glucose load. [3-3H]glucose was infused during the
initial 3 h of the insulin clamp to determine rates of endogenous
glucose production (EGP) and glucose disappearance (Rd).
During the 3-h euglycemic insulin clamp before glucose ingestion,
Rd was decreased (8.8 ± 0.5 vs. 7.6 ± 0.5 mg · kg
1 · min
1,
P < 0.01), and suppression of EGP was impaired
(0.2 ± 0.04 vs. 0.07 ± 0.03 mg · kg
1 · min
1,
P < 0.01). During the 4-h period after glucose
ingestion, SGU was significantly increased during the LIP vs. Sal
infusion study (30 ± 2 vs. 20 ± 2%, P < 0.005). In conclusion, an elevation in plasma FFA concentration impairs
whole body glucose Rd and insulin-mediated suppression of
EGP in healthy subjects but augments SGU.
liver; oral glucose; skeletal muscle
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