Summary
Intravenous glucose tolerance, release of immunoreactive insulin and the hypog'lycaemic response to exogenous insulin were investigated in nine normal, fifteen maturity-onset diabetic and twenty-five subjects (equivocal group) with a mild abnormality of oral glucose tolerance (Fasting blood glucose < 110 mg%, and two hour levels < 170 mg%). — Intravenous glucose tolerance (-K G.T.T.) and insulin sensitivity (K I.T.T.) of subjects in the equivocal group ranged from normal to low values, but were significantly different from the normal and frank diabetic groups. Within the equivocal group, eleven subjects had normal, eight diabetic and six borderlineK G.T.T. values. — Plasma insulin responses within the equivocal group varied widely: seven normal and seventeen typical diabetic responses occurred in individuals with either normal or reduced intravenous glucose tolerance. Despite this heterogeneity, a definite diagnosis was established in eleven of the twenty-five subjects with the present method of investigation. — Significant positive correlations were demonstrated both betweenK G.T.T. and plasma insulin andK G.T.T. and insulin sensitivity, suggesting that overall glucose tolerance is dependent on both insulin sensitivity and on the amount of circulating plasma insulin.
Résumé
La tolérance intraveineuse au glucose, la libération d'insuline immuno-réactive et la réaction hypoglycémique à l'insuline exogène furent examinées chez neuf sujets normaux, chez quinze sujets diabétiques de l'âge adulte et chez vingt-cinq sujets (groupe équivoque) ayant une anomalie bénigne de la tolérance au glucose par voie orale (glucose à jeun < 110 mg% et des taux de deux heures < 170 mg%). La tolérance intraveineuse au glucose (K G.T.T.) et la sensibilité à l'insuline (K I.T.T.) du groupe équivoque allaient des valeurs normales à des valeurs peu élevées mais étaient nettement différentes des groupes normaux et franchement diabétiques. Dans le groupe équivoque, onze sujets eurent des valeurs normales, huit des valeurs diabétiques et six des valeurs limites deK G.T.T. Les réponses de l'insuline plasmatique dans le groupe équivoque eurent de grandes variations: sept réponses normales et dix-sept réponses typiquement diabétiques apparurent chez les individus ayant soit une tolérance normale au glucose intraveineux, soit une tolérance réduite. Malgré cette hétérogénéité, un diagnostic définitif fut établi chez onze des vingt-cinq sujets avec cette méthode d'enquête. — Des corrélations d'une signification positive furent démontrées à la fois entreK G.T.T. et l'insuline plasmatique et entreK G.T.T. et la sensibilité à l'insuline, suggérant que la tolérance complète au glucose dépend à la fois de la sensibilité envers l'insuline et de la quantité d'insuline plasmatique qui circule.
Zusammenfassung
Die intravenöse Glucose-Toleranz, die Sekretion von immunreaktivem Insulin und die hypoglykaemische Reaktion auf exogenes Insulin wurde bei einer Reihe von Patienten untersucht: von diesen waren 9 normal, 15 hatten im reifen Alter einen Diabetes entwickelt, und 25 (eine Mittelgruppe) zeigten eine geringe Anomalie der oralen Glucose-Toleranz. (Blutzucker, nüchtern < 110 mg%, Werte nach 2 Std< 170 mg%). Die Messung der intravenösen Glucose-Toleranz (K G.T.T.) und der Insulin-Empfindlichkeit (K I.T.T.) von Patienten in der Mittelgruppe ergaben normale oder niedrige Werte, aber sie waren deutlich verschieden von denen in der normalen oder diabetischen Gruppe. Innerhalb der Mittelgruppe hatten 11 Patienten normale, 8 diabetische und 6 GrenzlinienK G.T.T. Werte. — Die Anstiege des Plasma Insulins in der Mittelgruppe fielen sehr verschieden aus: 7 normale und 17 typisch diabetische Reaktionen fanden sich bei Patienten, die eine normale oder erniedrigte intravenöse Glucose-Toleranz hatten. Trotz dieser Unterschiede war es möglich, eine definitive Diagnose bei 11 der 25 Patienten mit Hilfe dieser Untersuchungsmethode zu stellen. — Signifikante positive Beziehungen wurden festgestellt zwischenK G.T.T. und Plasma Insulin einerseits undK G.T.T. und Insulin-Empfindlichkeit andererseits. Daraus folgt, daß die Gesamt-Glucose-Toleranz abhängig ist nicht nur von der Insulin-Empfindlichkeit, sondern auch von der Menge des Plasma-Insulins im Blutkreislauf.
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Alford, F.P., Martin, P.I.R. & Pearson, M.J. The significance and interpretation of mildly abnormal oral glucose tolerance. Diabetologia 7, 173–180 (1971). https://doi.org/10.1007/BF01212550
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DOI: https://doi.org/10.1007/BF01212550