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The effect of small increases in blood glucose on insulin secretion and endogenous glucose production in humans

Version 3 2024-12-17, 22:13
Version 2 2024-11-26, 04:08
Version 1 2024-11-18, 00:50
journal contribution
posted on 2024-12-17, 22:13 authored by Clinton BruceClinton Bruce, Teddy Ang, Jason D Toms, Giang Minh DaoGiang Minh Dao, Jean Liu, Glenn M Ward, David N O’Neal, Dale J Morrison, Greg KowalskiGreg Kowalski
Small glycemic increments (≤0.5 mmol/L) can exert suppressive actions on endogenous glucose production (EGP) however it is unclear if this is an insulin dependent or independent process. Here, we performed a low-rate glucose infusion in control participants without diabetes and in people with type 1 diabetes (T1D) to better understand this phenomenon. Glucose kinetics, hormones and metabolites were measured during a 1 mg/kg/min glucose infusion (90 min) which rapidly increased glucose by ∼0.3 mmol/L in control participants. Insulin concentrations and secretion quickly increased by ∼20%, resulting in a ∼40% suppression of EGP, while glucose disposal remained unchanged. Free fatty acids (FFA) and glucagon were gradually suppressed to ∼30% below baseline at 60 min. When repeated under constant basal insulin concentrations in participants with T1D, glucose infusion caused only partial and transient EGP suppression, hence glucose increased in a near-linear manner, reaching levels ∼2 mmol/L above baseline at 90 min. FFAs and glucagon remained unchanged, while glucose disposal modestly increased. This demonstrates that small glycemic increments exert subtle stimulatory effects on insulin secretion that have potent metabolic actions on the liver and adipose tissue. It is conceivable that subtle increases in glucose could potentially serve as a signal for β-cell adaptation.

History

Journal

Diabetes

Pagination

1-3

Location

Alexandria, Va.

ISSN

0012-1797

eISSN

1939-327X

Language

eng

Publication classification

C4 Letter or note

Publisher

American Diabetes Association

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