Affiliation:
1. Center for Human Nutrition Washington University School of Medicine St. Louis Missouri USA
2. School of Medicine University of Missouri Columbia Missouri USA
3. Sansum Diabetes Research Institute Santa Barbara California USA
Abstract
AbstractObjectiveThe objective of this study was to evaluate the relative importance of the basal rate of glucose appearance (Ra) in the circulation and the basal rate of plasma glucose clearance in determining fasting plasma glucose concentration in people with obesity and different fasting glycemic statuses.MethodsThe authors evaluated basal glucose kinetics in 33 lean people with normal fasting glucose (<100 mg/dL; Lean < 100 group) and 206 people with obesity and normal fasting glucose (Ob < 100 group, n = 118), impaired fasting glucose (100–125 mg/dL; Ob100–125 group, n = 66), or fasting glucose diagnostic of diabetes (≥126 mg/dL; Ob ≥ 126 group, n = 22).ResultsAlthough there was a large (up to three‐fold) range in glucose Ra within each group, the ranges in glucose concentration in the Lean < 100, Ob < 100, and Ob100–125 groups were small because of a close relationship between glucose Ra and clearance rate. However, the glucose clearance rate at any Ra value was lower in the hyperglycemic than the normoglycemic groups. In the Ob ≥ 126 group, plasma glucose concentration was primarily determined by glucose Ra, because glucose clearance was markedly attenuated.ConclusionsFasting hyperglycemia in people with obesity represents a disruption of the precisely regulated integration of glucose production and clearance rates.image
Funder
American Diabetes Association
Longer Life Foundation
National Institutes of Health
Subject
Nutrition and Dietetics,Endocrinology,Endocrinology, Diabetes and Metabolism,Medicine (miscellaneous)