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Glucose intolerance in uremia (A- and B-cell function during conservative and dialytic management)

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Summary

Glucose tolerance and insulin and glucagon secretion were investigated in two groups of uremic patients, respectively on conservative and hemodialytic treatment. For this purpose, a glucose infusion was performed in the fasting state. Glucose intolerance was observed in uremic patients; hemodialysis improved, but did not normalize the glucose disposal. In uremic patients both on conservative and dialytic treatment plasma insulin and glucagon levels were higher than in the control group; the pattern of glucagon suppression was well maintained. The data obtained suggest that glucose intolerance in uremia is related mainly to peripheral insulin resistance and is not due to hyperglucagonemia.

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References

  1. Alleyne G. A. O., Fraser H. S., Besterman H. S.: Some Effects of Metabolic Acidosis on Carbohydrate Metabolism in the Rat - Clin. Sci.39, 375, 1970.

    PubMed  CAS  Google Scholar 

  2. Assan R.:In Vivo Metabolism of Glucagon - In:Lefèbvre P. J., Unger R. H. (Eds): Glucagon: Molecular Physiology, Clinical and Therapeutic Implications. Pergamon Press, Oxford, 1972; p. 47.

    Google Scholar 

  3. Balestri P. L., Rindi R., Biagini M., Giovannetti S.: Effects of Uraemic Serum, Creatinine and Methyl-Guanidine on Glucose Metabolism - Clin. Sci.42, 395, 1972.

    PubMed  CAS  Google Scholar 

  4. Bilbrey G. L., Faloona G. R., White M. G., Atkins C., Hull A. R., Knochel J. P.: Hyperglucagonemia in Uremia: Reversal by Renal Transplantation - Ann. intern. Med.82, 525, 1975.

    PubMed  CAS  Google Scholar 

  5. Bilbrey G. L., Faloona G. R., White M. G., Knochel J. P.: Hyperglucagonemia of Renal Failure - J. clin. Invest.53, 841, 1974.

    PubMed  CAS  Google Scholar 

  6. Bishel M., Sabin N., Homola B., Barbour B. N.: Albumin Turnover in Chronically Hemodialyzed Patients - Trans. Amer. Soc. artif. intern. Org.15, 298, 1969.

    Google Scholar 

  7. Cerletty J. M., Engbring H. H.: Azotemia and Glucose Intolerance- Ann. intern. Med.66, 1097, 1967.

    PubMed  CAS  Google Scholar 

  8. Chamberlain M. J., Stimmler L.: The Renal Handling of Insulin - J. clin. Invest.46, 911, 1967.

    PubMed  CAS  Google Scholar 

  9. Cohen J. B.: Abnormal Carbohydrate Metabolism in Renal Disease - Ann. intern. Med.57, 204, 1962.

    PubMed  CAS  Google Scholar 

  10. De Fronzo R. A., Andres R., Edgar P., Walker W. G.: Carbohydrate Metabolism in Uremia: a Review - Medicine (Baltimore)54, 469, 1973.

    Google Scholar 

  11. Dole V. P., Meinertz H.: Microdetermination of Long-Chain Fatty Acids in Plasma and Tissues — J. biol. Chem.235, 2595, 1960.

    PubMed  CAS  Google Scholar 

  12. Emmanouel D. S., Jaspan J. B., Kuku S. F., Rubenstein A. H., Katz A. I., Huen A. H. J.: Pathogenesis and Characterization of Hyperglucagonemia in the Uremic Rat — J. clin. Invest.58, 1266, 1976.

    PubMed  CAS  Google Scholar 

  13. Gerich J. E., Karam J. H., Forsham P. H.: Stimulation of Glucagon Secretion by Epinephrine in Man — J. clin. Endocr.37, 479, 1973.

    Article  PubMed  CAS  Google Scholar 

  14. Giordano C., Esposito R., Desanto N. G., De Pascale C.: Dietary Treatment in Acute and Chronic Renal Failure — Proc. 3rd Int. Congr. Nephrology, Washington 25–30 September 1966; abstract. Quoted byMerrill J. P. andHampers C. L.: Uremia. Progress in Pathophysiology and Treatment. Grune and Stratton, Inc., New York, 1971; p. 18.

  15. Giovannetti S., Maggiore Q.: A Low Nitrogen Diet with Proteins of High Biological Value for Severe Chronic Uremia — Lancet1, 1000, 1964.

    Article  PubMed  CAS  Google Scholar 

  16. Hampers C. L., Soeldner J. S., Doak P. B., Merrill J. P.: Effect of Chronic Renal Failure and Hemodialysis on Carbohydrate Metabolism — J. clin. Invest.45, 1719, 1966.

    PubMed  CAS  Google Scholar 

  17. Heidland A., Kuat J.: Long-Term Effects of Essential Amino Acids Supplementation in Patients on Regular Dialysis Treatment — Clin. Nephrol.3, 234, 1975.

    PubMed  CAS  Google Scholar 

  18. Herbert V., Lau K. S., Gottlieb C. W., Bleicher S. J.: Coated Charcoal Immunoassay of Insulin — J. clin. Endocr.25, 1375, 1965.

    PubMed  CAS  Google Scholar 

  19. Horton E. S., Johnson C., Lebovitz H. E.: Carbohydrate Metabolism in Uremia — Ann. intern. Med.68, 63, 1968.

    PubMed  CAS  Google Scholar 

  20. Hutchings R. H., Hegstrom R. M., Scribner B. H.: Glucose Intolerance in Patients on Long-Term Intermittent Dialysis — Ann. intern. Med.65, 275, 1966.

    Google Scholar 

  21. Lindall A., Carmena R., Cohen S., Comity C.: Insulin Hypersecretion in Patients on Chronic Hemodialysis. Role of Parathyroids — J. clin. Endocr.32, 653, 1971.

    PubMed  CAS  Google Scholar 

  22. Lindsey C. A., Santeusanio F., Brateen J., Faloona G. R., Unger R. H.: Pancreatic Alpha-Cell Function in Trauma — J. Amer. med. Ass.227, 757, 1974.

    Article  CAS  Google Scholar 

  23. Lowrie E. G., Soeldner J. S., Hampers C. L., Merrill J. P.: Glucose Metabolism and Insulin Secretion in Uremic, Prediabetic, and Normal Subjects — J. Lab. clin. Med.76, 603, 1970.

    PubMed  CAS  Google Scholar 

  24. Marco J., Calle C., Roman D., Diaz Ferros M., Villanueva M. L., Valverde J.: Hyperglucagonemia Induced by Glucocorticoid Treatment in Man — New Engl. J. Med.288, 128, 1973.

    Article  PubMed  CAS  Google Scholar 

  25. Mattingly D.: A Simple Fluorimetric Method for the Estimation of Free 11-Hydroxycorticoids in Human Plasma — J. clin. Path.15, 374, 1964.

    Google Scholar 

  26. Merrill P. J., Hampers C. L.: Uremia, Progress in Pathophysiology and Treatment — Grune & Stratton, Inc., New York, 1971.

    Google Scholar 

  27. Myers V. C., Killian J. A.: Studies in Animal Diastases. The Increased Diastase Activity of the Blood in Diabetic and Nephritis — J. biol. Chem.29, 179, 1917.

    CAS  Google Scholar 

  28. Navalesi R., Pilo A., Lenzi S., Donato L.: Insulin Metabolism in Chronic Uremia and in the Anephric State: Effect of the Dialytic Treatment — J. clin. Endocr.40, 70, 1975.

    Article  PubMed  CAS  Google Scholar 

  29. Neubauer E.: Über Hyperglykämie bei Hochdrucknephritis und die Beziehungen zwischen Glykämie und Glycosurie beim Diabetes mellitus — Biochem. Z.25, 285, 1910.

    Google Scholar 

  30. Ohneda A., Aguilar-Parada E., Eisentraut A. M., Unger R. H.: Characterization of Response of Circulating Glucagon to Intraduodenal and Intravenous Administration of Amino Acids — J. clin. Invest.47, 2305, 1968.

    PubMed  CAS  Google Scholar 

  31. Ørskov H., Christensen N. J.: Growth Hormone in Uremia. I. Plasma Growth Hormone, Insulin and Glucagon after Oral and Intravenous Glucose in Uremic Subjects — Scand. J. clin. Lab. Invest.27, 51, 1971.

    PubMed  Google Scholar 

  32. Paloyan D., Paloyan E., Worobec R., Ernst K., Deininger E., Harper P. V.: Serum Glucagon Levels in Experimental Acute Pancreatitis in the Dog — Surg. Forum17, 348, 1966.

    PubMed  CAS  Google Scholar 

  33. Paloyan E.: Recent Developments in the Early Diagnosis of Hyperparathyroidism — Surg. Clin. N. Amer.47, 61, 1967.

    PubMed  CAS  Google Scholar 

  34. Paloyan E., Paloyan D., Harper P. V.: Glucagon-Induced Hypocalcemia — Metabolism16, 35, 1967.

    Article  PubMed  CAS  Google Scholar 

  35. Perkoff J. T., Thomas C. L., Newton J. D., Sellman J. C., Tyler F. H.: Mechanism of Impaired Glucose Tolerance in Uremia and Experimental Hyperazotemia — Diabetes7, 735, 1958.

    Google Scholar 

  36. Radaelli B., Salvadeo A., Ponticelli C., Imbasciati E., Graziani G.: Aspetti del metabolismo glucidico nell’uremico cronico sottoposto ad emodialisi periodica — Minerva nefrol.14, 158, 1967.

    Google Scholar 

  37. Rocha D. M., Faloona G. R., Unger R. H.: Glucagon-Stimulating Activity of 20 Amino Acids in Dogs — J. clin. Invest.51, 2346, 1972.

    PubMed  CAS  Google Scholar 

  38. Rocha D. M., Santeusanio F., Faloona G. R., Unger R. H.: Abnormal Pancreatic Alpha Cell Function in Bacterial Infection — New Engl. J. Med.288, 700, 1973.

    Article  PubMed  CAS  Google Scholar 

  39. Rubenstein A. H., Mako M. E., Horwitz D. L.: Insulin and the Kidney — Nephron15, 306, 1975.

    PubMed  CAS  Google Scholar 

  40. Santeusanio F., Faloona G. R., Knochel J. P., Unger R. H.: Evidence for a Role of Endogenous Insulin and Glucagon in the Regulation of Potassium Homeostasis — J. Lab. clin. Med.81, 809, 1973.

    PubMed  CAS  Google Scholar 

  41. Sharffer G., Heinze V., Jontonfsohn R., Katz N., Rippich T., Schafer B., Zimmerman W., Kluthe R.: Amino Acids and Protein Intake in RDT Patients. A Nutritional and Biochemical Analysis — Clin. Nephrol.3, 228, 1975.

    Google Scholar 

  42. Spergel G., Bleicher S. J., Goldberg M., Adesman J., Goldner M. G.: The Effect of Potassium on the Impaired Glucose Tolerance in Chronic Uremia — Metabolism16, 581, 1967.

    Article  CAS  Google Scholar 

  43. Spitz I. M., Rubenstein A. H., Bersohn I., Abrahams C., Lowy C.: Carbohydrate Metabolism in Renal Disease — Quart. J. Med.39, 201, 1970.

    PubMed  CAS  Google Scholar 

  44. Unger R.H., Aguilar-Parada E., Müller W. A., Eisentraut A. M.: Studies of Pancreatic Alpha Cell Function in Normal and Diabetic Subjects — J. clin. Invest.49, 837, 1970.

    Article  PubMed  CAS  Google Scholar 

  45. Westervelt F. B., Shreiner G. E.: The Carbohydrate Intolerance of Uremic Patients — Ann. intern. Med.57, 226, 1962.

    Google Scholar 

  46. Willmore D. W., Lindsey C. A., Moylan J., Faloona G. R., Pruitt B., Unger R. H.: Hyperglucagonaemia after Burns — Lancet1, 73, 1974.

    Article  Google Scholar 

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Authors and Affiliations

  1. Istituto di Clinica Medica Generale E Terapia Medica Istituto di Patologia Speciale Medica E Metodologia Clinica, Università di Perugia, Italy

    Massimo Massi Benedetti, Gabriella Angeletti, Umberto Buoncristiani, Fausto Santeusanio, Paolo Filipponi & Paolo Brunetti

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  1. Massimo Massi Benedetti
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  2. Gabriella Angeletti
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  3. Umberto Buoncristiani
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Benedetti, M.M., Angeletti, G., Buoncristiani, U. et al. Glucose intolerance in uremia (A- and B-cell function during conservative and dialytic management). Acta diabet. lat 14, 235–249 (1977). https://doi.org/10.1007/BF02580972

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