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The effect of ingested glucose dose on the suppression of endogenous glucose production in humans

Version 2 2024-06-04, 06:42
Version 1 2017-08-04, 10:59
journal contribution
posted on 2024-06-04, 06:42 authored by Greg KowalskiGreg Kowalski, Samantha MooreSamantha Moore, S Hamley, Ahrathy SelathuraiAhrathy Selathurai, Clinton BruceClinton Bruce
Insulin clamp studies have shown that the suppressive actions of insulin on endogenous glucose production (EGP) are markedly more sensitive than for stimulating glucose disposal (Rd). However, clamp conditions do not adequately mimic postprandial physiological responses. Here, using the variable infusion dual-tracer approach, we used a threefold range of ingested glucose doses (25, 50, and 75 g) to investigate how physiological changes in plasma insulin influence EGP in healthy subjects. Remarkably, the glucose responses were similar for all doses tested, yet there was a dose-dependent increase in insulin secretion and plasma insulin levels. Nonetheless, EGP was suppressed with the same rapidity and magnitude (∼55%) across all doses. The progressive hyperinsulinemia, however, caused a dose-dependent increase in the estimated rates of Rd, which likely accounts for the lack of a dose effect on plasma glucose excursions. This suggests that after glucose ingestion, the body preferentially permits a transient and optimal degree of postprandial hyperglycemia to efficiently enhance insulin-induced changes in glucose fluxes, thereby minimizing the demand for insulin secretion. This may represent an evolutionarily conserved mechanism that not only reduces the secretory burden on β-cells but also avoids the potential negative consequences of excessive insulin release into the systemic arterial circulation.

History

Journal

Diabetes

Volume

66

Pagination

2400-2406

Location

United States

ISSN

0012-1797

eISSN

1939-327X

Language

English

Publication classification

C Journal article, C1 Refereed article in a scholarly journal

Copyright notice

2017, The American Diabetes Association

Issue

9

Publisher

AMER DIABETES ASSOC