Effect of hyperglycemia per se on glucose disposal and clearance in noninsulin-dependent diabetics.

Abstract

To determine the relationship between the plasma glucose level and the rate of glucose disposal in patients with noninsulin-dependent diabetes mellitus (NIDDM), the glucose disposal rate was measured by isotope dilution ([3-3H] glucose infusion) at two different glucose levels but at the same insulin level in seven patients with untreated NIDDM [fasting plasma glucose, 263 ± 26 (mean ± SEM)]. The infusion of somatostatin (500 μg/h) and insulin (30 mU/m2-min) produced fixed peripheral insulin levels of 61 ± 4 μU/ml. When the plasma glucose level was kept at 96 ± 2 mg/dl with a variable rate glucose infusion, the glucose disposal rate was 222 ± 13 mg/min, and the glucose clearance rate (glucose disposal rate ÷ plasma glucose level) was 232 ± 14 ml/min. Increasing the glucose level to 191 ± 4 mg/dl produced a significant rise (P < 0.001) in glucose disposal to 391 ± 32 mg/min, while glucose clearance fell significantly (P < 0.005) to 204 ± 13 ml/min. Thus, although the rise in the glucose level caused an inc...