The Blood Sugar and Serum Insulin Response to Intravenous Glucagon in Chronic Renal Failure

The Effect of Dialysis on the Carbohydrate Intolerance of Chronic Renal Failure

“…In fact, there is considerable evidence indicating that astate of insulin resistance is present in renal failure. The elevated levels of fasting serum insulin (Horton, Johnson and Liebovitz, 1968;Spitz et al, 1970;Briggs et al, 1970), exaggerated insulin responses to oral glucose and glucagon (Cerletty and Engbring, 1967;Horton, Johnson and Liebovitz, 1968;Spitz et al, 1970;Briggs et al, 1967;Spitz, Rubenstein, Bersohn and van As, 1970), and decreased sensitivity to exogenous insulin (Perko!! et al, 1958;Wester!elt and Schreiner, 1962;Spitz et al, 1970;Cohen, 1962), all support this concept.…”

“…The elevated levels of fasting serum insulin (Horton, Johnson and Liebovitz, 1968;Spitz et al, 1970;Briggs et al, 1970), exaggerated insulin responses to oral glucose and glucagon (Cerletty and Engbring, 1967;Horton, Johnson and Liebovitz, 1968;Spitz et al, 1970;Briggs et al, 1967;Spitz, Rubenstein, Bersohn and van As, 1970), and decreased sensitivity to exogenous insulin (Perko!! et al, 1958;Wester!elt and Schreiner, 1962;Spitz et al, 1970;Cohen, 1962), all support this concept. Elsewhere we have shown that blood urea and serum creatinine correlate with both the degree of glucose intolerance and insulin resistance as measured by t~e fall in blood sugar following intravenous insulin administration (Spitz et al, 1970).…”

“…In order to minimize interassay variations, serum insulin and growth hormone sarnples taken from each patient during different tests were assayed together. The values obtained in our laboratory for blood sugar, serum insulin and plasma FF A in control subjects have been reported previously (Spitz et al, 1970) (Tab. 2).…”

“…Most subjects show peripheral resistance to the action of exogenous insulin (Perkof!. Thomas, Newton, Sellman and Tyler, 1958;Hampers, So eiden er, Doak and Merrill, 1966;Cerletty and Engbring, 1967;Horton, Johnson and Liebovitz, 1968;Spitz, Rubenstein, Bersohn, .. Supported by a grant from the South African Sugar Industry and the Fisher Endocrine Research Fund.…”

“…Received: Feb. 20, 1970 Accepted: Mar. 9, 1970 Abrahams and Lowy, 1970) and high levels of endogenous insulin following the ingestion of a glucose load (Cerletty and Engbring, 1967;Horton, Johnson and Liebovitz, 1968;Spitz et al, 1970;Briggs, Buchanan, Luke and McKiddie, 1967). Furthermore, these patients show a diminished hypoglycemic response to intravenous tolbutamide (Hampers et al, 1966;Cerletty and Engbring, 1967;Spitz et al, 1970) and raised levels of circulating growth hormone (Horton, Johnson and Liebovitz, 1968;Wright, Lowy, Fraser, Spitz, Rubenstein and Bersohn, 1968).…”