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Articles in PresS, published online ahead of print March 26, 2002
Am J Physiol Endocrinol Metab, 10.1152/ajpendo.00178.2001
Submitted on April 19, 2001
Accepted on March 25, 2002
1 Department of Internal Medicine, Division of Endocrinology, Metabolism, & Nutrition, Mayo Clinic & Foundation, Rochester, MN, USA
2 Department of Internal Medicine, Division of Gastroenterology, Mayo Clinic & Foundation, Rochester, MN, USA
3 Pediatrics & Adolescent Medicine, Mayo Clinic & Foundation, Rochester, MN, USA
* To whom correspondence should be addressed. E-mail: rizza.robert{at}mayo.edu.
Glucose tolerance is better when glucose is ingested than when the same amount is injected intravenously. To determine if enteral delivery of glucose selectively influences splanchnic glucose metabolism in nondiabetic humans, ten subjects were studied on two occasions. On one occasion, glucose was infused into the duodenum (ID) at a rate of 22 µmol/kg/min and supplemental glucose was infused intravenously whereas on the other occasion all glucose was infused intravenously (IV) while saline was infused intraduodenally. On both occasions, hormone secretion was inhibited with somatostatin and glucose (~8.5 mmol/L) and insulin (~450 pmol/L) were maintained at constant but elevated levels. Initial splanchnic glucose extraction was calculated using intravenously infused [6,6-2H2] glucose to trace the systemic rate of appearance of intraduodenally infused [3-3H] glucose while flux through the UDP-glucose pool (an index of hepatic glycogen synthesis) was measured using the acetaminophen glucuronide method. Despite differences in the route of glucose delivery, endogenous glucose production was comparably suppressed (3.5 ± 1.0 vs. 3.3 ± 1.0 µmol/kg/min,) and total glucose disappearance comparably stimulated (78.9 ± 5.7 vs. 85.0 ± 7.2 µmol/kg/min) on the ID and IV study days. Initial splanchnic glucose extraction, (17.5 ± 4.4 vs. 14.5 ± 2.9%) and the flux through the hepatic UDP-glucose pool (9.0 ± 2.0 vs. 10.3 ± 1.5 µmol/kg/min) also did not differ on the ID and IV study days. These data argue against the existence of an "enteric" factor that directly (i.e. independent of changes of circulating hormone concentrations) enhances splanchnic glucose uptake or hepatic glycogen synthesis in nondiabetic humans.
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