Cortisone Glucose Tolerance Tests Research Articles

Altered glucose tolerance in carbon disulfide exposed workers.

Oral cortisone glucose tolerance tests were performed in 66 CS2-exposed workers and in 66 individually matched control subjects. Results indicate a higher and significant (p less than 0.001) prevalence of latent diabetes in the CS2-exposed group (72.7%) as compared with the control group (16.7%), and the existence of a positive and significant (p less than 0.001) correlation between blood glucose values and exposure index. Possible mechanisms of action involving zinc metabolism and pyridoxine metabolism are discussed.

Plasma insulin concentration in the femoral, hepatic, and pancreatico-duodenal veins in dogs during standard and cortisone glucose tolerance tests

Comparison of glucose tolerance tests carried out with or without cortisone showed the advantage of the former when testing the internal secretory function of the pancreas. With the aid of this test the insulin secretion during glucose loading was found to be biphasic. The dynamics of the blood insulin level in the pancreatico-duodenal vein reflects insulin secretion by the pancreas better than the dynamics of its concentration in the blood of the peripheral veins.

Letter: Phenformin for treating diabetes mellitus.

Comments and Correction1 May 1976Phenformin and Lactic AcidosisSTANLEY A. BLUMENTHAL, M.D., F.A.C.P., DAVID H. P. STREETEN, M.B., D.PHIL., F.R.C.P.STANLEY A. BLUMENTHAL, M.D., F.A.C.P.Search for more papers by this author, DAVID H. P. STREETEN, M.B., D.PHIL., F.R.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-84-5-615 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We wish to correct a statement that appeared in our recent "Letter" (Ann Intern Med84:55-56, 1976). In our discussion of a patient with phenformin-related lactic acidosis, we indicated that the increase in phosphofructokinase activity, and hence the increase in glycolytic production of lactic acid, was caused by a fall in cytosolic ATP concentration. This is probably not true. Current biochemical evidence suggests that intracellular ATP levels do not regulate glycolysis because they change very little, even under anoxic conditions, and that increases or decreases in phosphofructokinase activity are closely related to concordant changes in cytosolic AMP...Reference1. NEWSHOLMESTART EC: Regulation in Metabolism. London, John Wiley & Sons, 1973, pp. 105-132 Google Scholar1. WILLIAMSPALMER RJ: Farewell to phenformin for treating diabetes mellitus. Ann Intern Med 83:567-568, 1975 LinkGoogle Scholar2. WILANSKYHAHN DI: Modification of latent diabetes by short-term phenformin administration. Metabolism 16:199-203, 1967 CrossrefMedlineGoogle Scholar3. FALUDIBENDERSKYGERBER GGP: Functional hypoglycemia in early latent diabetes. Ann NY Acad Sci 148:868-874, 1968 CrossrefMedlineGoogle Scholar4. BERGERDOWNEYTRAISMAN SJH: Effect of phenformin on the cortisone glucose tolerance test. Ann NY Acad Sci 148:859-867, 1968 CrossrefMedlineGoogle Scholar5. ARKYABRAHAMSON RE: Insulin response to glucose in the presence of oral hypoglycemics. Ann NY Acad Sci 148:768-777, 1968 CrossrefMedlineGoogle Scholar6. LUKENSDOHANWOLCOTT FFM: Pituitary diabetes in the cat: recovery following phloridzin treatment. Endocrinology 32:475-487, 1943 CrossrefGoogle Scholar7. STOWERSBEWSHERBRACKENRIDGE JPR: Trial of chlopropamide in subclinical diabetes. Diabetes 11(suppl):127-130, 1962 MedlineGoogle Scholar8. WILANSKYSHOCHAT DG: The course of latent diabetes. Ann NY Acad Sci 148:848-858, 1968 CrossrefMedlineGoogle Scholar9. CRAWFORDBODE JH: Diabetes and the amplifier hypothesis. N Engl J Med 282:1266-1267, 1970 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: STANLEY A. BLUMENTHAL, M.D., F.A.C.P.; DAVID H. P. STREETEN, M.B., D.PHIL., F.R.C.P.Affiliations: VA Hospital Department of Medicine State University of New York Upstate Medical Center Syracuse, NY 13210 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDrug Interactions with Antimicrobial AgentsDrug Interactions with Agents Used to Treat Endocrine DisordersCIRRHOSIS IN SOUTH WALESPHENFORMIN-INDUCED LACTICACIDOSIS PRECIPITATED BY TETRACYCLINELactic acidosis in biguanide-treated diabeticsDiabetes MellitusInsulin, glucagon and oral hypoglycaemic drugsPhenformin in Diabetes MellitusLUBOMIR J. VALENTA, M.D. 1 May 1976Volume 84, Issue 5Page: 615-616KeywordsAdenosine monophosphateAdenosine triphosphateAttentionFallsLactic acidLactic acidosis ePublished: 1 December 2008 Issue Published: 1 May 1976 PDF downloadLoading ...

Letter: Generalized granuloma annulare.

To the Editor.— According to the Test Your Knowledge quiz in the October issue of theArchives(110:604, 1974) regarding generalized granuloma annulare, it is true that There is no significant association with diabetes. article by Dicken et al 1 cited as a reference in the Answer section, described two patients with frank diabetes mellitus and two with mildly elevated fasting blood sugar levels among 26 cases of generalized granuloma annulare. authors did not consider this data insignificant, but instead concluded that The finding of four such patients in 26 is higher than the usual expectancy, and this finding warrants further study. In a later report by Haim et al, 2 four cases of overt diabetes and three of latent or chemical diabetes were found among eight patients with generalized granuloma annulare. Mobacken et al 3 reported finding one patient with an abnormal cortisone glucose tolerance test among

Abnormalities of myocardial depolarization in overt, subclinical and prediabetes. A vectorcardiographic study.

Vectorcardiograms were performed on fifteen diabetic patients, and all were found to have either the vectorcardiographic criteria for myocardial infarction or “bites.” Twenty adults with normal fasting blood sugars and not known to be diabetics were found to have bites; eleven (55 per cent) had an abnormal glucose tolerance test; four of the remaining nine were tested further and three (75 per cent) had an abnormal cortisone glucose tolerance test. Four apparently normal children, age four to twelve, from two families were studied. In both families, the mother had insulindependent diabetes and the father had subclinical diabetes. All four children had vectorcardiographic abnormalities. This pilot study indicates that if the vectorcardiographic criteria for myocardial damage are correct, then it exists at an earlier stage in diabetes than has previously been recognized. Alternatively, if a morphologic abnormality cannot be demonstrated then a physiologic explanation must be advanced to account for these vectorcardiographic abnormalities.

Glucose, insulin, HGH, and cortisol plasma levels in granuloma annulare patients during glucose tolerance and cortisone glucose tolerance test

Glucose, insulin, human growth hormone and cortisol levels are reported during both a standard glucose tolerance test and a cortisone-glucose tolerance test in eleven Granuloma Annulare patients and five healthy subjects. Although little difference seemed to exist between these two groups during the standard GTT they differed significantly (p

Evidence for Impaired Glucose Tolerance in Uncomplicated Psoriasis

In a small but highly selected series of patients with uncomplicated psoriasis we found four patients with abnormal results from an oral glucose tolerance test (OGTT) and 13 of 34 patients (38%) of those with a normal OGTT value who had an abnormal cortisone glucose tolerance test (CGTT) result. This degree of abnormal glucose tolerance mimics the frequency of impaired tolerance in the close relatives of known diabetics. While our findings are preliminary, they are unique in that only uncomplicated psoriatics were studied. On the basis of our findings, we believe that the clinician would be well advised to evaluate each psoriasis patient for diabetes and to be alert to diabetes developing when selecting treatment for, and in observing, the patient with psoriasis.

Carbohydrate metabolism in children: (1) Blood sugar, serum insulin, and growth hormone during oral glucose tolerance tests; (2) Blood sugar during the cortisone glucose tolerance test

Oral glucose tolerance tests have been performed on 159 children 1 wk to 12 yr of age, using capillary specimens. Mean glucose responses varied only between the 1 1 2 –3- yr age group and the 3–12-yr group at 60 min post-glucose ingestion. There were no agerelated differences in insulin and growth hormone responses. Cortisone glucose tolerance tests have been carried out with 113 normal children without a family history of diabetes, and the data analyzed by age group ( 1 1 2 yr-<4 yr, 4-<8 yr, 8–12 yr ). The responses of the youngest group differed significantly from those of children older than 4 yr. There were no significant sex differences. The responses of the children 4–12 yr of age provide standards for this test.

Insulin production and glucose tolerance in patients with granuloma annulare.

Summary.— Ten patients with granuloma annulare were studied for evidence of carbohydrate intolerance. By traditional criteria, 2 had an abnormal glucose tolerance test. Of the remaining 8,3 had an abnormal cortisone-glucose tolerance test. The findings indicate a higher incidence (50%) of glucose intolerance in these patients than is found in the average population. In the cortisone-glucose tolerance test, plasma insulin response to glucose loading was significantly lower in the population of 10 patients with granuloma annulare than in a normal control group. The remaining 4 granuloma annulare patients with normal glucose values in both the standard and cortisone-induced glucose tolerance tests were aiso evaluated by measuring plasma insulin response to glucose loading. These 4 patients, when evaluated as a group, demonstrated also a significantly lower insulin response to glucose than the control population. These results suggest a decreased pancreatic beta cell sensitivity to glucose stimulation in patients with granuloma annulare.

Formation of 14CO 2 and 3HOH from glucose-1- 14C, -1- 3H during oral cortisone glucose tolerance tests in obese patients

Glucose-1- 14C was given to 10 nonobese and 19 obese adult female subjects in the oral load of a cortisone glucose tolerance test (CGTT); the extent of reduction of expiration of 14CO 2 in the obese was compared with the abnormality of the blood glucose concentration curve of CGTT and the k value of an intravenous glucose tolerance test (IGTT) in the same patients. In some patients glucose-1- 3H was also included in the oral load and the rate of formation of tritiated body water ( 3HOH) taken as a general measure of glucose utilization. Obese patients excreted only about half as much 14CO 2 as nonobese subjects during the first 90 min after ingestion and about two thirds as much after 3 hr. Calculation of total formed breath and body 14CO 2 indicated similar differences. At a time (2 hr) of maximum difference in blood glucose concentration in the CGTT that of the obese group was 25 per cent higher than that of the nonobese, with much less significance of difference than for the 14CO 2. The mean k value of the IGTT for the obese group was 60 per cent of that for the nonobese group. Within the obese group the reduction in total formed 14CO 2 was highly correlated with the nonisotopic parameters of glucose tolerance and was correlated to a lesser extent with parameters of obesity. Since formation of 3HOH from glucose-1- 3H was not significantly reduced in the obese group, the abnormality of metabolism of glucose-1- 14C in the obese patients appears to be a diversion of 14C to some organic products with concomitant decrease in formation of 14CO 2. The tritium data suggest no decrease in the absorption or overall initial utilization of glucose.

ALVEOLAR BONE LOSS AS A PROGNOSTIC SIGN OF DIABETES IN PATIENTS OF THE 60‐PLUS AGE GROUP

Abstract: This study was undertaken in 19 presumably healthy elderly persons, to see if there was any relationship between alveolar bone loss and carbohydrate metabolism. In 9 of the subjects, alveolar bone loss, as determined by periapical radiography of the anterior teeth and graded on a 7‐point scale, was correlated with carbohydrate metabolism as judged from the results of the conventional glucose tolerance test. In the other 10 subjects, alveolar bone loss, estimated on a percentage basis, was correlated with carbohydrate metabolism judged according to the results of the cortisone glucose tolerance test. Within the limits of this study, there appeared to be a relationship between bone loss and blood glucose concentration. The subjects with the greatest bone loss had the highest blood glucose levels.

Levels of Plasma Insulin During Cortisone Glucose Tolerance Tests in “Nondiabetic” Relatives of Diabetic Patients: Implications of Diminished Insulin Secretory Reserve in Subclinical Diabetes

Plasma levels of insulin were determined during standard oral glucose tolerance tests and during cortisone glucose tolerance tests performed upon “nondiabetic” subjects (normal standard GTT) who were first degree relatives of diabetic patients. The standard test was also performed upon mildly diabetic patients and healthy control subjects. The results of the standard glucose tolerance test (levels of plasma insulin and blood glucose) did not differentiate the relatives with positive cortisone glucose tolerance tests (subclinical diabetes) from those with negative cortisone glucose tolerance tests although in both groups levels of plasma insulin were lower than in healthy subjects. However, the results of the cortisone glucose tolerance test did distinguish the group with subclinical diabetes from the relatives with negative tests since the secretion of insulin was delayed and insufficient in the subjects with positive testsl During the standard test patients with mild “maturityonset” diabetes showed delayed and insufficient secretion of insulin as compared to the healthy subjects. It is concluded that during the cortisone glucose tolerance test, “nondiabetic” relatives of diabetic patients who have positive tests (subclinical diabetes) exhibit a defect in the secretion of insulin which distinguishes them from subjects with negative tests. This defect is similar in pattern to that observed in mildly diabetic patients during the standard test. This deficiency in the secretion of insulin represents an important part of the mechanism which induces a positive cortisone glucose tolerance test. This demonstration that, in some relatives of diabetics, a grossly normal standard glucose tolerance can exist at a time when decreased reserve insulin secretory capacity can be measured, justifies a careful evaluation of whether some form of therapy is indicated at this stage of the disease (subclinical diabetes) and, if so, what form it should be. The meaning of the statistically significant subnormal response of plasma insulin to a standard glucose load in relatives with negative cortisone glucose tests is not yet apparent. Since in them the reserve insulin secretory capacity, as measured by the CGTT, remains intact, it is premature, pending additional data, to raise the question of possible treatment of this group.

Granuloma annulare. Cortisone-glucose tolerance test in a non-diabetic group.

Granuloma annulare. Cortisone-glucose tolerance test in a non-diabetic group.

Insulin-sensitivity and insulin-insensitivity in Indian diabetics as determined by the insulin tolerance test and their influence on the therapeutic response to tolbutamide

The insulin tolerance test (ITT) was used to determine the incidence of insulin-sensitivity and insulin-insensitivity in 123 male Indian diabetics. The patients were then treated with diet plus tolbutamide and followed up for 24 months and improvement in their diabetic state as influenced by insulin-sensitivity and insulin-insensitivity was determined. Normal preprandial and postprandial blood sugars were obtained in 94 % of insulin-sensitive and 62.5 % of insulin-insensitive patients. Under continued therapy, 60 % of insulin-sensitive and 65 % of insulin-insensitive patients had a normal glucose tolerance test. The insulin-insensitive patients did not improve any further but 20 % of insulin-sensitive patients achieved a normal cortisone-glucose tolerance test.

Cortisone Glucose Tolerance Tests in Infants and Children

Cortisone Glucose Tolerance Tests in Infants and Children

Glucose tolerance tests in the early puerperium

Patients with normal glucose tolerance both during pregnancy and in the nonpregnant state were studied on the third and fourth days after normal deliveries with normal postpartum courses. Regular oral and cortisone glucose tolerance tests in the early puerperium were found to be invalid, yielding 54 and 86.5 per cent false positive results, respectively. Possible reasons for the false results obtained when such tests are done under the usual circurmstances surrounding the early puerperium are discussed. Nevertheless, these findings suggest that these tests are too unreliable to be of practical value at this time. The paradox of decreased glucose tolerance in the normal puerperium and the precipitous drop in insulin requirement in the diabettc patient in the early puerperium is discussed.

Effect of phenformin on the cortisone glucose tolerance test.

Effect of phenformin on the cortisone glucose tolerance test.

Lipid and carbohydrate studies in coronary artery disease.

Twenty-seven patients with arteriographically proved coronary artery disease, aged 27 to 59 years, were studied for abnormalities of lipid or carbohydrate metabolism. All patients were referred because of cardiac symptoms and none had any prior history of lipid or carbohydrate abnormality. Twenty-three patients were found to have some abnormality of carbohydrate or lipid metabolism, and four had none. Seventeen patients had an abnormal lipoprotein electrophoretic pattern, 12 had elevated serum cholesterol concentrations, and 15 elevated serum triglyceride values. Eighteen patients had an abnormality of carbohydrate metabolism, 11 as determined on standard glucose tolerance tests and seven on cortisone glucose tolerance tests. These abnormalities of carbohydrate and lipid metabolism were not related to age or ponderal-index ratio. This high incidence of carbohydrate and lipid abnormalities in association with coronary artery disease may be important in the pathogenesis of the vascular disease as well as management of these patients and their progeny.

Secretion of insulin induced by amino acids and glucose in diabetes mellitus.

ABSTRACT A mixture of 10 essential amino acids and 1-arginine alone were administered intravenously to patients with mild maturityonset type of diabetes, to subjects with subclinical diabetes (normal standard glucose tolerance test but abnormal cortisone-glucose tolerance test) and to healthy subjects. In addition, glucose was administered orally to each group of subjects. Amino acid-induced secretion of insulin was subnormal in mild maturity-onset type of diabetes, and a similar but less marked defect was also found in subjects with subclinical diabetes mellitus. These 2 groups also secreted less insulin in response to oral glucose than did the healthy subjects. The demonstration of subnormal insulin secretion in patients with mild diabetes and in subjects with subclinical diabetes in response to the infusion of amino acids as well as to orally administered glucose points again to functional impairment of pancreatic islets at these stages of the disease.

Modification of latent diabetes by short-term phenformin administration

Data are presented which tend to confirm the authenticity of the cortisone glucose tolerance test as a method of predicting the later occurrence of diabetes, in diabetic relatives. Administration of the oral hypoglycemic agent, phenformin, for 6 weeks induced remission in the carbohydrate abnormality of latent diabetes in 40–55 per cent of subjects lasting 3 years following its discontinuation. A 6 week course of Phenformin appears to have prophylactic value in retarding the onset of diabetes in latent diabetics for 3 years following its administration.