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Diabetes Care 25:2042-2047, 2002
© 2002 by the American Diabetes Association, Inc.

Pathophysiology
Original Article

Influence of Metabolic Control on Splanchnic Glucose Uptake, Insulin Sensitivity, and the Time Required for Glucose Absorption in Patients With Type 1 Diabetes

Petra Georg, MD1, Alexandra Kautzky-Willer, MD1, Katja Mahdjoobian, MD1, Astrid Hofer, RN1, Rudolf Prager, MD1, Giovanni Pacini, DSC2 and Bernhard H. Ludvik, MD1

1 Division of Endocrinology and Metabolism, Department of Internal Medicine III, University of Vienna, Vienna, Austria
2 Institute of Biomedical Engineering (ISIB-CNR), National Research Council, Padova, Italy

OBJECTIVE—The relationship between splanchnic glucose uptake (SGU) after oral glucose administration and metabolic control in type 1 diabetic patients is controversial. We estimated SGU as well as peripheral glucose uptake and the time required for glucose absorption by a validated method, the oral glucose (OG) clamp, in type 1 diabetic patients with different levels of long-term glycemic control.

RESEARCH DESIGN AND METHODS—An OG clamp (which combines a hyperinsulinemic clamp [120 mU · m-2 · min-1] with an OR load [75 g] during steady-state glucose uptake) was performed in eight type 1 diabetic patients with good metabolic control (DG) (HbA1c 6.1 ± 0.2%, BMI 23.1 ± 0.7 kg/m2), eight type 1 diabetic patients with poor metabolic control (DP) (HbA1c 8.5 ± 0.3%, BMI 25.4 ± 1.4 kg/m2), and eight healthy matched control subjects (C) (HbA1c 5.1 ± 0.1%, BMI 25 ± 1.3 kg/m2) to determine SGU, glucose uptake, and glucose absorption.

RESULTS—Glucose uptake calculated from 120 to 180 min during the clamp was 9.13 ± 0.55 mg · kg-1 · min-1 in C, 8.18 ± 0.71 mg · kg-1 · min-1 in DG, and 7.42 ± 0.96 mg · kg-1 · min-1 in DP (NS). Glucose absorption was 140 ± 6 min in C, 156 ± 4 min in DG, and 143 ± 7 min in DP (NS). The respective calculated SGU was 14.5 ± 5.6% in C, 17.8 ± 3.1% in DG, and 18.8 ± 4.2% in DP (NS) and did not correlate with HbA1c values.

CONCLUSIONS—Peripheral glucose uptake, SGU after oral glucose administration, and the glucose absorption time were not different in type 1 diabetic patients independent of glycemic control when compared with healthy subjects.

Abbreviations: C, control subjects • DG, type 1 diabetic patients with good metabolic control • DP, type 1 diabetic patients with poor metabolic control • GINF, glucose infusion rate • GINFOG, GINF during oral glucose absorption • GINF(t), GINF during resorption time • OG, oral glucose • OGL, OG load • SGU, splanchnic glucose uptake


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Copyright © 2002 by the American Diabetes Association.