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Am J Physiol Endocrinol Metab (April 2, 2002). doi:10.1152/ajpendo.00424.2001
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Articles in PresS, published online ahead of print April 2, 2002
Am J Physiol Endocrinol Metab, 10.1152/ajpendo.00424.2001
Submitted on September 21, 2001
Accepted on March 24, 2002

Regulation of endogenous glucose production after a mixed meal in Type 2 diabetes

Parag Singhal1, Andrea Caumo2, Peter E. Carey1, Claudio Cobelli2, and Roy Taylor1*

1 School of Clinical Medical Sciences, University of Newcastle, Newcastle upon Tyne, United Kingdom
2 Department of Electronics and Informatics, University of Padova, Padova, Italy

* To whom correspondence should be addressed. E-mail: roy.taylor{at}ncl.ac.uk.

The extent and time course of suppression of endogenous glucose production (EGP) in type 2 diabetes following a mixed meal has been determined using a new tracer methodology. Groups of age, sex and weight matched normal controls (n=8) and diet controlled Type 2 diabetic subjects (n=8) were studied after ingesting a standard mixed meal (550 kcal, 67% carbohydrate, 19% fat, 14% protein). There was an early insulin increment in both groups such that by 20 min plasma insulin levels were 266±54 and 190±53 pmol/l respectively. Endogenous glucose production was similar basally (2.55±0.12 mg/kg/min in control vs. 2.92±0.16 mg/kg/min in the patients (p=0.09)). After glucose ingestion, EGP declined rapidly in both groups to approximately 50% of basal within 30 min of the meal. Despite the initial rapid decrease, the EGP was significantly greater in the diabetic group at 60 min (1.75±0.12 vs. 1.05±0.14 mg/kg/min; p< 0.01) and did not reach a nadir until 210 min (0.96±0.17 mg/kg/min). Between 60 and 240 min, EGP was 47% higher in the diabetic group (0.89±0.09 vs. 1.31±0.13 mg/kg/min, p<0.02). These data quantitate the initial rapid suppression of EGP after a mixed meal in Type 2 diabetes and the contribution of continuing excess glucose production to subsequent hyperglycemia.




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