Insulin response to intravenous glucose in patients with anorexia nervosa showing low insulin response to oral glucose.

Abstract

To investigate the cause of a low insulin secretory response to an oral glucose tolerance test (OGTT) in patients with anorexia nervosa (AN), we performed iv glucose tolerance tests (IVGTT) before and after treatment in 36 anorectic patients who showed low insulin secretion in response to the OGTT. These patients were subdivided into 3 groups by glucose tolerance curves during the OGTT: normal type, blood glucose level peaking 60 min or earlier after oral glucose ingestion; delayed type, blood glucose level peaking 90 min or later after oral glucose; and flat type, peak blood glucose level of 5.56 mmol/L or less after oral glucose. The results showed that the normal and flat type groups had normal glucose and insulin responses to iv glucose. In the delayed type group, in which the longest duration of AN before therapy was found, initial insulin secretion was decreased in response to both oral and iv glucose, indicating diminished pancreatic beta-cell function. After weight gain, this parameter improved significantly in both tests. The rate of glucose disappearance for the IVGTT was lower both before and after weight gain in this subgroup compared to that in normal controls, suggesting insulin resistance. In conclusion, the low insulin response to oral glucose seen in the flat type group may be due to the disturbance of gastrointestinal factors, such as motility. In contrast, the observations suggest that the delayed type group has beta-cell failure corrected by weight gain and has insulin resistance requiring a longer recovery time; these abnormalities are related to the duration of AN.

Anti-LFA-1 Improves Pig Islet Xenograft Function in Diabetic Mice When Long-Term Acceptance Is Induced by CTLA4Ig/Anti-CD40L

“…The AUC was calculated using the trapezoidal approach. The K G was calculated as the slope of the decimal log of the glucose concentration at 10 -30 min after glucose injection (20,21).…”

Plasma Levels of Intact and Degraded Ghrelin and Their Responses to Glucose Infusion in Anorexia Nervosa

“…Such data support the hypothesis that elevated ghrelin secretion reflects energy demand and stimulates GH secretion in AN. However, antibodies for measuring plasma ghrelin levels in previous studies have been against C-terminus ghrelin (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28) (3,5,6), ghrelin (1-11) (7) or full-length ghrelin with or without octanoylation at Ser 3 (8 -11). Concentrations of intact ghrelin actually represent less than 10% of total circulating ghrelin levels, which include acylated and desacylated ghrelin immunoreactivities (12).…”

A characteristic reactive hypoglycemia induced by rapid change of eating behavior in anorexia nervosa: A case report

“…Metabolic changes in patients with AN, particularly carbohydrate metabolism, have been well documented (Herzog & Copeland, 1981). Some studies have revealed changes in insulin sensitivity (Kiriike et al, 1990), insulin resistance (Scheen, Castillo, & Lefebvre, 1988), and a spectrum of glucose and insulin response patterns to the oral glucose tolerance test (OGTT; Nozaki et al, 1994). Several studies also suggest that carbohydrate metabolism is closely related to nutritional status and eating behavior (Russell, Hooper, & Hunt, 1996).…”