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Query: UMLS:C0432222 (SEM)
 47,337 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Female pet dogs exhibiting either glucose intolerance alone or glucose intolerance and acromegaly were investigated. Some dogs developed the disorder(s) during dioestrus and some animals developed the disorder(s) after they were given medroxyprogesterone acetate (MPA). Elevated fasting plasma glucose levels (12.3 +/- 1.9 mM, mean +/- SEM) were accompanied by fasting hyperinsulinaemia (144 +/- 21 microU/ml, mean +/- SEM) and drastic elevation of plasma growth hormone (GH) levels (112.6 +/- 45 ng/ml, mean +/- SEM). An iv glucose tolerance test (IVGTT) performed on all dogs revealed non-suppressibility of GH levels and glucose intolerance. Plasma concentrations of glucose, insulin and GH during IVGTT in affected dogs differed significantly from the concentrations measured in normal dogs during the same test. MPA withdrawal and/or ovariohysterectomy (OVx-HYx) in affected animals was followed by reversal of GH levels to normal and improved glucose tolerance. Acromegaly associated soft tissue changes were also reversible after MPA withdrawal and/or OVx-HYx when GH levels had dropped. In 5 dogs which had developed diabetes during dioestrus and in which a spontaneous decrease in plasma progesterone occurred during the investigation a concomittant decrease in GH levels was observed. Plasma GH measured at different stages of pregnancy in 45 dogs was found to be elevated in one animal only. The results show that the development of spontaneous diabetes/acromegaly occurring in some female dogs is related to progestagen (progesterone/MPA) exposure and that reversal of the signs is achieved by progesterone/MPA withdrawal. The results suggest that diabetes/acromegaly in the dogs studied was caused by progesterone/MPA-evoked GH elevation. Finally, the findings also suggest that the GH axis normally not appreciably responsive to progestagen exposure in some dogs becomes and/or is paradoxically controlled by physiologic levels of endogenous progesterone or low doses of MPA.
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PMID:Progesterone-controlled growth hormone overproduction and naturally occurring canine diabetes and acromegaly. 622 90

The amount-of-substance rate of glucose metabolism and its sensitivity to the concentration of insulin was quantified in 10 non-diabetic patients with alcoholic cirrhosis of varying severity, using the 'glucose clamp technique'. Fasting glucose and insulin were 5.4 +/- 0.3 mmol/l and 187 +/- 50 pmol/l (mean +/- SEM), respectively. During the hyperglycaemic clamp (blood glucose at 12.5 mmol/l) the glucose metabolic rate (divided by body mass) was 27 +/- 4 mumol X min-1 X kg-1 at an insulin concentration of 998 +/- 158 pmol/l. Thus the insulin sensitivity of the tissue glucose metabolism was 22 +/- 7 m3 X min-1 X kg-1. During the euglycaemic clamp exogenous insulin was given to a concentration of 574 +/- 72 pmol/l. The resulting glucose metabolic rate was 20 +/- 4 mumol X min-1 X kg-1 and the insulin sensitivity the same as during hyperglycaemia. The calculated systemic delivery rate of insulin (divided by body surface area) was 783 +/- 172 pmol X min-1 X m-2. Fasting glucagon was 32 +/- 5 pmol/ and only partly depressed by glucose or insulin. In comparison with stated relevant control groups cirrhotics exhibit glucose intolerance characterized by decreased sensitivity to insulin, hyperinsulinaemia due to increased release, and hyperglucagonaemia with decreased suppressibility. There was no relation between clinical or biochemical data of the patients and the above results, suggesting that the abnormal glucose metabolism does not depend directly on the decreased liver function but on a disturbed pancreatic-hepatic-peripheral axis.
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PMID:Insulin sensitivity in alcoholic cirrhosis. 636 75

To study beta-cells response during liver cirrhosis, OGTT (0.75 g/kg b.w.) was performed in 7 cirrhotic patients (histologically diagnosed). An impaired glucose tolerance was observed in all the subjects: basal plasma glucose was 0.74 g/l +/- 0.05 (M +/- SEM); at 90 min was 1.50 g/l +/- 0.10, and at 180 min was 1.10 g/l +/- 0.17. Plasma insulin peak was delayed at 90 min (78.2 microU/ml +/- 27.7); two patients showed basal hyperinsulinemia. C peptide concentration reached the peak at 120 min (3.6 ng/ml +/- 0.5), in agreement with Gragnoli and coll. Plasma insulin concentration did not correlate with hepatic laboratory findings. All the patients had severe liver disease, including esophageal varices; in 4 patients ascites was observed. The results show that impaired glucose tolerance in patients with liver cirrhosis is not directly related to the degree of the disease and confirm the decreased insulin catabolism and peripheric resistance.
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PMID:[Beta-cell activity during the oral glucose tolerance test in subjects with hepatic cirrhosis]. 638 29

We have previously reported that normal Wistar rats fed an isocaloric, sucrose-rich (63%) diet (SRD) developed glucose intolerance and elevated triglyceride levels in plasma as well as in heart and liver tissue. This metabolic state was accompanied by hyperinsulinism both in vivo and in vitro, suggesting that a state of insulin resistance has developed. The aim of this study was to gather information on the various plasma post-heparin lipolytic activities in rats fed a SRD. Hepatic triglyceride lipase (H-TGL) was evaluated by both, protamine sulfate inhibition (PSI) of extrahepatic lipoprotein lipase (LPL) and heparin-Sepharose affinity chromatography (H-SAC). Both methods rendered comparable results. Total triglyceride lipase (T-TGL) was measured after Krauss et al. and monoglyceride hydrolase (MGH) after Vogel et al. Our results have shown a significant decline of plasma T-TGL (5.32 +/- 0.34 means +/- SEM vs. 7.48 +/- 0.64 mumol glycerol ml-1 h-1; p less than 0.01), H-TGL (3.71 +/- 0.28 vs. 5.05 +/- 0.69; p less than 0.05), LPL (1.61 +/- 0.26 vs. 2.42 +/- 0.41; p less than 0.05) and MGH (558 +/- 108 mumol glycerol l-1 min-1 vs. 1,165 +/- 45; p less than 0.001) activities. Thus, feeding a sucrose-rich diet induced a state of hyperlipemia and insulin resistance in which not only plasma T-TGL but also H-TGL and MGH activities were significantly decreased. This suggests that the latter two enzymes are also under nutritional and/or hormonal control.
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PMID:Post-heparin plasma hepatic triglyceride lipase and monoglyceride hydrolase activities in hyperlipemia induced by a sucrose rich diet. 661 28

To determine whether sustained control of hyperglycaemia in Type 2 (non-insulin-dependent) diabetic patients would diminish proteinuria, the effect of hypocaloric diet therapy (500 kcal/day) on proteinuria was assessed in obese, Type 2 diabetic patients (n = 24) and compared with results obtained for obese subjects with normal glucose tolerance (n = 7) and impaired glucose tolerance (n = 6). Diet therapy of similar mean duration resulted in similar percentage weight loss (mean percentage of original weight +/- SEM) in diabetic (13.6 +/- 1.6%), glucose intolerant (16.4 +/- 3.3%) and obese non-diabetic (11.0 +/- 1.0%) subjects. Following therapy, plasma glucose concentrations 2h after an oral glucose load declined in the diabetic (18.34 +/- 0.81 to 10.67 +/- 0.50 mmol/l, mean +/- SEM; p less than 0.001) and in the glucose intolerant subjects (10.2 +/- 0.3 to 7.3 +/- 0.4 mmol/l, p less than 0.01) while remaining unchanged in the obese non-diabetic subjects (7.09 +/- 0.23 to 6.77 +/- 0.32 mmol/l, NS). Concentrations of total protein of plasma origin and albumin in 24-h urine collections were quantified by a sensitive immunonephelometric assay using specific antisera. Initially, 24-h excretion of total protein and albumin were elevated in the diabetic [mg protein/24 h; (median +/- 95% confidence limits): 63 (42-138), p less than 0.05; albumin: 26 (14-56), p less than 0.05] and glucose intolerant subjects [protein: 52 (13-92), NS; albumin: 24 (3-61), NS] compared with the non-diabetic subjects [protein: 20 (5-38); albumin: 6.2 (3.5-9.5)].(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sustained reduction of proteinuria in type 2 (non-insulin-dependent) diabetes following diet-induced reduction of hyperglycaemia. 671 34

Hepatic glucose production and metabolic clearance rate of glucose were measured using (3-3H) glucose at steady state, basally and during two sequential 2 h insulin (25 and 40 mU . kg -1 . h -1)/glucose (2 and 3 mg. kg -1 . min -1) infusion periods. Eight diabetic subjects were studied before and after 1 week of twice daily insulin therapy; six control subjects matched for age, weight and degree of obesity were also studied. In the diabetic patients, pre-treatment hepatic glucose production was 20.0 +/- 2.2, 9.9 +/- 2.9, and 1.4 +/- 0.8 mu mol . kg -1 . min -1 respectively (+/- SEM) for each of the three periods, and fell significantly with treatment to 12.8 +/- 1.7, 4.0 +/- 1.5 and 1.9 +/- 1.0 mu mol . kg -1 . min -1. Hepatic glucose production in normal subjects was 13.2 +/- 0.6, 2.2 +/- 0.8 and less than 1 mu mol . kg -1 . min -1. The pre-treatment metabolic clearance rate in all diabetic studies with insulin levels greater than or equal to 30 mU/l was 1.10 +/- 0.14 ml . kg -1 . min -1 and remained virtually unchanged following insulin therapy; this was significantly lower than in the control subjects (6.83 +/- 1.02, p less than 0.001). Basal non-esterified fatty acid levels were higher (p less than 0.02) in the pre-treated diabetic patients compared to post-treated diabetic patients and control subjects. Non-esterified fatty acids in each group fell to similar levels during the insulin infusions, but the rate of fall was slower in the pre-treated diabetic patients. Insulin receptor binding to erythrocytes was normal in the diabetic subjects and unchanged by treatment. Therefore, following insulin treatment of uncontrolled Type 2 (non-insulin-dependent) diabetes, the initially increased basal hepatic glucose production, and decreased hepatic sensitivity, return towards normal. However, the glucose clearance remains low, despite good diabetic control, and appears to be a major factor in the continuing glucose intolerance. As insulin receptor binding is normal, the defect of glucose clearance in Type 2 diabetes appears compatible with a post-receptor defect of glucose metabolism.
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PMID:Differential effects of insulin therapy on hepatic and peripheral insulin sensitivity in Type 2 (non-insulin-dependent) diabetes. 675 16

Continuous insulin infusion (CII) was used to increase intravenous glucose tolerance in 10 extremely premature (26.2 +/- 0.04 weeks, means +/- SEM) very low birth weight (819 +/- 53 g) hyperglycemic infants. CII was continued for 3-36 days. Over the first 72 h of insulin administration the mean amount of glucose tolerated rose from 0.35 +/- 0.06 to 0.67 +/- 0.06 g/kg/h and caloric intake derived from intravenous glucose increased from 29 to 56 kcal/kg/day. Insulin doses required to maintain normoglycemia ranged from 0.005-0.052 U/kg/h initially to 0.002-0.086 U/kg/h after 72 h of CII. Plasma insulin levels were significantly higher during insulin infusion. The low insulin doses required to maintain normoglycemia were consistent with a state of relative insulin deficiency, rather than insulin resistance. Mean plasma insulin/glucose ratios were significantly higher in normoglycemic versus hyperglycemic infants (0.40 +/- 0.08 vs. 0.14 +/- 0.05). Less than 1% of all blood glucose estimations were less than 25 mg/dl. Seventy-eight percent were within the normal range (greater than 45, less than 130 mg/dl). The rate of weight gain increased during CII in 8 of the 10 infants. CII may be useful in extremely premature, very-low-birth-weight infants in whom glucose intolerance persists despite conservative treatment, and either severely limits caloric intake, or results in life-threatening hyperglycemia.
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PMID:Continuous insulin infusion in hyperglycemic, very low birth weight infants. 676 6

Of 30 patients with chronic liver disease 16 showed some degree of impairment of glucose tolerance, and 16 patients had lack of suppression of raised fasting growth hormone levels or showed an anomalous rise after oral glucose. No relationship, however, existed between the state of glucose tolerance and the presence of abnormal growth hormone levels. Plasma glucose in those with normal growth hormone response at 0, 1/2, 1, 1-1/2, and 2 hours, after 50 g glucose were 5.55 +/- 0.41 mmol/l, 8.71 +/- 0.59, 10.66 +/- 0.99, 10.28 +/- 1.37, 8.90 +/- 1.40 (mean +/- SEM; n = 14). Under the same conditions those with abnormal growth hormone responses showed values of 5.32 +/- 0.59, 7.83 +/- 0.81, 9.41 +/- 0.95, 9.46 +/- 0.99, 8.69 +/- 0.98. At no time were the differences significantly different as judged by Student's t test. Measurement of serum insulin indicated a relative deficiency in patients with impaired tolerance. It is concluded that the abnormal growth hormone is not directly responsible for the impaired glucose tolerance.
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PMID:Impaired glucose tolerance and growth hormone in chronic liver disease. 701 88

Patients with growth hormone deficiency (GHD) have traditionally been described as having increased insulin sensitivity with a tendency toward fasting hypoglycemia, at least in children. In other studies, impaired glucose tolerance has been found. To evaluate basal insulin sensitivity, a hyperinsulinemic, normoglycemic clamp was performed with an insulin rate of 40 mU/m2/min after an overnight fast. Fifteen patients (four women and 11 men aged 20 to 62 years) with GHD for at least 1 year were compared with 15 healthy controls matched for sex, age, and body mass index (BMI). Thirteen patients had complete pituitary deficiency and were being treated with conventional hormone replacement therapy. Two men had isolated GHD since childhood. Four men were being treated with bromocriptin. There were no significant differences between fasting blood glucose (4.4 +/- 0.1 v 4.7 +/- 0.2 [mean +/- SEM] mmol/L) or fasting plasma insulin (9.5 +/- 1.4 v 8.8 +/- 1.1 mU/L) in patients and controls, respectively. Fasting free fatty acid (FFA) levels were lower in patients (444 +/- 35 v 796 +/- 94 mumol/L, P < .01). Blood glucose levels during the clamp were similar (4.6 +/- 0.1 v 4.9 +/- 0.1 mmol/L), as were insulin levels (81 +/- 4 v 93 +/- 4 mU/L). A decrease in glucose infusion rate (GIR) was seen during the clamp in GHD subjects (3.9 +/- 0.5 v 9.9 +/- 0.7 mg/kg body weight/min) as compared with controls (P = .001). Even if corrections were made for body fat, there was a significant difference (GIR corrected per lean body mass, 5.8 +/- 0.8 v 13.9 +/- 0.9 mg/kg lean body mass/min, P < .001). The results suggest that adults with GHD are insulin-resistant. Despite this finding, normal fasting plasma insulin levels were seen.
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PMID:Growth hormone-deficient adults are insulin-resistant. 766 85

Recent evidence suggests that the postprandial hyperglycaemia in impaired glucose tolerance is primarily due to impaired suppression of basal hepatic glucose output. This in turn appears to be secondary to decreased first phase insulin secretion, although decreased hepatic insulin sensitivity, which is a feature of non-insulin-dependent diabetes mellitus, might also play a role. Eight mildly overweight subjects with impaired glucose tolerance and eight closely matched control subjects with normal glucose tolerance underwent an intravenous glucose tolerance test to assess first phase insulin secretion. Insulin sensitivity was examined by a 150-min hyperinsulinaemic-euglycaemic clamp. Somatostatin was infused from 150 min to suppress endogenous insulin secretion, and glucagon and insulin were replaced by constant infusion. Glucose with added dideuterated glucose (labelled infusion technique) was infused to maintain euglycaemia. First phase insulin secretion (delta 0-10 min insulin area divided by delta 0-10 min glucose area) was significantly decreased in the subjects with impaired glucose tolerance (median [range]: 1.2 [0.2-19.4] vs 9.1 [2.6-14.5] mU.mmol-1; p < 0.01). During the clamp, circulating insulin (93 +/- 8 [mean +/- SEM] and 81 +/- 10 mU.l-1) and glucagon (54 +/- 4 and 44 +/- 6 ng.l-1) levels were comparable. Total glucose disposal was decreased in subjects with impaired glucose tolerance (2.78 +/- 0.27 vs 4.47 +/- 0.53 mg.kg-1.min-1; p < 0.02), and was primarily due to decreased non-oxidative glucose disposal. However, hepatic glucose output rates were comparable during the clamp (0.38 +/- 0.10 and 0.30 +/- 0.18 mg.kg-1.min-1).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Peripheral and hepatic insulin sensitivity in subjects with impaired glucose tolerance. 767 92


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