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• W2054335968 abstract "Objective. An autoregulatory mechanism involving a reciprocal relationship between gluconeogenesis and glycogenolysis regulates endogenous glucose production (EGP) in healthy individuals. In type 2 diabetes, fasting hyperglycemia may be due to increased EGP. Material and methods. To examine gluconeogenesis and autoregulation of EGP in type 2 diabetes, 9 type 2 diabetics and 8 healthy controls were studied during a 3‐h infusion of 30 µmol/kg/min Na‐lactate. The diabetics were also studied during a control infusion of Na‐bicarbonate. To standardize levels of glucoregulatory hormones, plasma insulin, growth hormone, and glucagon were clamped at identical levels during the three experiments. Glucagon levels were elevated from basal levels to ∼330 ng/l when the lactate or bicarbonate infusions were started, in order to mimic the hyperglucagonemia often seen in diabetes. Lactate gluconeogenesis and total EGP were measured by infusions of [6‐3H] glucose and [U‐14C] lactate. Results. In the bicarbonate experiments, hyperglugagonemia increased lactate gluconeogenesis in the diabetic patients from 4.3±1.8 to 6.1±2.4 µmol/kg/min (p = 0.04). EGP did not change significantly (basal EGP: 15.3±3.9, EGP at the end of the study: 14.2±3.9 µmol/kg/min, p = 0.14). During both lactate experiments, plasma lactate increased more than 4‐fold. The increase in lactate gluconeogenesis was significantly higher in diabetics than in controls (values obtained at the end of experiments minus basal values: 10.8±3.6 versus 6.4±3.6 µmol/kg/min, p = 0.03). Compared with normal subjects, the diabetic patients had higher EGP values both at basal conditions (p = 0.001) and during lactate infusion (p = 0.005). Despite augmented gluconeogenesis, EGP did not change during lactate and glucagon infusion in any of the groups (diabetics, basal EGP: 15.4±2.7 versus EGP at the end of experiments: 15.6±3.6 µmol/kg/min, p>0.30. Controls, basal EGP: 11.8±0.8 versus EGP at the end of experiments: 11.6±1.9 µmol/kg/min, p>0.30). Conclusions. Althought type 2 diabetics have increased EGP and increased lactate gluconeogenesis, the hepatic autoregulation of EGP during increased substrate‐induced gluconeogenesis seems to be intact." @default.
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• W2054335968 date "2005-06-01" @default.
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• W2054335968 title "Type 2 diabetic patients have increased gluconeogenic efficiency to substrate availability, but intact autoregulation of endogenous glucose production" @default.
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• W2054335968 doi "https://doi.org/10.1080/00365510510025692" @default.
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