Skip to main content
SpringerLink
Log in

B-cell response to a standardized breakfast in end-stage renal failure

  • Original Contributions
  • Published:
Acta diabetologia latina Aims and scope Submit manuscript

Summary

Twelve uremic patients (U) on regular hemodialysis were submitted to a standardized test meal. In comparison with normal controls (C), U patients demonstrated a slight increase of HbA1 level and a definite elevation of fasting plasma C-peptide immunoreactivity. They showed glucose intolerance at 60 and 120 min. This was associated with an inappropriate insulin response as evidenced by a significantly lower insulin/glucose index at 60 min. U patients were tested again during a hemodialysis session in order to reduce the 60-min glucose intolerance. Six patients (U1) were selected because they exhibited mean fasting and 60-min glucose values similar to those of the controls. In these conditions, the insulin response at 60 min was significantly decreased in comparison to basal conditions and this could not be accounted for by a concomitant decrease of plasmaα-aminonitrogen values. It is concluded that, in uremic patients, glucose intolerance is associated with an inappropriately low B-cell response.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bagdade J. D., Porte D. Jr., Curtis F. F., Bierman E. L.: Uremic lipemia: an unrecognized abnormality in triglyceride synthesis and removal — Trans. Ass. Amer. Phycns81, 190, 1968.

    CAS  Google Scholar 

  2. Briggs J. D., Buchanan K. D., Luke R. G., McKiddie M. T.: Role of insulin in glucose intolerance in uremia — Lanceti, 462, 1967.

    Article  CAS  Google Scholar 

  3. Casparie A. F., Miedema K.: Glycosylated haemoglobin in diabetes and renal failure — Lancetii, 758, 1977.

    Article  Google Scholar 

  4. Cerletty J. M., Engbring N. H.: Azotemia and glucose intolerance — Ann. intern. Med.66, 1097, 1967.

    PubMed  CAS  Google Scholar 

  5. Chamberlain M. J., Stimmler L.: The renal handling of insulin — J. clin. Invest.46, 911, 1967.

    PubMed  CAS  Google Scholar 

  6. Dandona P., Freedman D., Moorhead J. F.: Glycosylated haemoglobin in chronic renal failure — Brit. med. J.i, 1183, 1979.

    Article  Google Scholar 

  7. Daubresse J. C., Lerson G., Plomteux G., Rorive G., Luyckx A. S., Lefebvre P. J.: Lipids and lipoproteins in chronic uremia. A study of the influence of regular haemodialysis — Europ. J. clin. Invest.6, 159, 1976.

    PubMed  CAS  Google Scholar 

  8. DeFronzo R. A., Tobin J. D., Rowe J. W., Andres R.: Glucose intolerance in uremia. Quantification of pancreatic beta cell sensitivity of glucose and tissue sensitivity to insulin — J. clin. Invest.62, 425, 1978.

    PubMed  CAS  Google Scholar 

  9. Ferrannini E., Pilo A., Navalesi R., Citti L.: Insulin kinetics and glucose-induced insulin delivery in chronically dialysed subjects: acute effects of dialysis — J. clin. Endocrinol.49, 15, 1979.

    Article  CAS  Google Scholar 

  10. Floyd J. C., Fajans S. S., Conn J. W., Knopf R. F., Rull J.: Stimulation of insulin secretion by amino acids — J. clin. Invest.45, 1487, 1966.

    PubMed  CAS  Google Scholar 

  11. Fluckiger R., Harmon W., Meier W., Loo S., Gabbay K. H.: Hernoglobin carbamylation in uremia — New Engl. J. Med.304, 823, 1981.

    Article  PubMed  CAS  Google Scholar 

  12. 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 

  13. Hampers C. L., Soeldner J. S., Gleason R. E., Bailey G. L., Diamond J. H., Merrill J. P.: Insulin-glucose relationship in uremia — Amer. J. clin. Nutr.21, 414, 1968.

    PubMed  CAS  Google Scholar 

  14. Horton E. S., Johnson C., Lebovitz H. E.: Carbohydrate metabolism in uremia — Ann. intern. Med.68, 63, 1968.

    PubMed  CAS  Google Scholar 

  15. Horwitz D. L., Starr J. L., Mako M. E., Blackerd W. G., Rubenstein A. H.: Proinsulin, insulin and C-peptide concentration in human portal and peripheral blood — J. clin. Invest.55, 1278, 1975.

    Article  PubMed  CAS  Google Scholar 

  16. Hutchings R. H., Hegstrom R. M., Schribner B. H.: Glucose intolerance in patients on long-term intermittent dialysis — Ann. intern. Med.65, 275, 1966.

    Google Scholar 

  17. Kajinuma H., Kanazawa Y., Sando H., Hayashi M., Kawazu S., Kosaka K.: Human plasma C-peptide immunoreactivity: its correlation with immunoreactive insulin in diabetes and chronic liver and renal diseases — Endocrinol. jap.26, 65, 1979.

    CAS  Google Scholar 

  18. Kawai K., Hayakawa H., Yoshida K., Shimizu M., Noto Y., Ohno T., Morita N., Hattori N.: Plasma insulin and C-peptide levels in cirrhotic and uremic patients — Diabète et Métab.3, 7, 1977.

    CAS  Google Scholar 

  19. Kynoch P. A. M., Lehmann M.: Rapid estimation (2 1/2 hrs) of glycosylated haemoglobin for routine purposes — Lancetii, 16, 1977.

    Article  Google Scholar 

  20. Lefebvre P. J., Luyckx A. S., Nizet A. H.: Independence of glucagon and insulin handling by the isolated perfused dog kidney — Diabetologia12, 359, 1976.

    Article  PubMed  CAS  Google Scholar 

  21. Malengeau P., Bourdon R., Nicaise A. M., Masson B.: Dosage des acides aminés dans les liquides de l’organisme — Ann. Biol. clin.21, 1, 1963.

    Google Scholar 

  22. Mako M., Block M., Starr J., Nielsen E., Friedman E., Rubenstein A. H.: Proinsulin in chronic renal and hepatic failure: a reflection of the relative contribution of the liver and kidney to its metabolism — Clin. Res.21, 631, 1973.

    Google Scholar 

  23. Massi-Benedetti M., Angeletti G., Buoncristiani U., Santeusanio F., Filipponi P., Brunetti P.: Glucose intolerance in uremia (A- and B-cell function) during conservative and dialytic management — Acta diabetol. lat.14, 235, 1977.

    Article  Google Scholar 

  24. Mondon C. E., Dolkas C. B., Reaven G. M.: The site of insulin resistance in acute uremia — Diabetes27, 571, 1978.

    Article  PubMed  CAS  Google Scholar 

  25. Muller W. A., Faloona G. R., Aguilar-Parada E., Unger R. H.: Abnormal alpha-cell function in diabetes — New Engl. J. Med.283, 109, 1970.

    Article  PubMed  CAS  Google Scholar 

  26. O’Brien J. P., Sharpe A. R.: The influence of renal disease on the insulin disappearance curve in man — Metabolism16, 76, 1967.

    Article  PubMed  CAS  Google Scholar 

  27. Perkoff G. T., Thomas C. L., Newton J. D., Sellman J. C., Tyler F. H.: Mechanism of impaired glucose tolerance in uremia and experimental hyperazotemia — Diabetes7, 375, 1958.

    PubMed  CAS  Google Scholar 

  28. Rabkin R., Simon N. M., Steiner S., Colwell J. A.: Effect of renal disease on renal uptake and excretion of insulin in man — New Engl. J. Med.282, 182, 1970.

    Article  PubMed  CAS  Google Scholar 

  29. Ramirez G., O’Neill W. M., Bloomer H. A., Jubiz W.: Serum C-peptide in renal failure patients following stimulation of pancreatic secretion — Clin. Nephrol.11, 297, 1979.

    PubMed  CAS  Google Scholar 

  30. Regeur L., Faber O. K., Binder C.: Plasma C-peptide in uraemic patients — Scand. J. clin. Lab. Invest.38, 771, 1978.

    PubMed  CAS  Google Scholar 

  31. Roth D. A., Meade R. C., Barboriak J. J.: Glucose, insulin and free fatty acids in uremia — Diabetes22, 111, 1973.

    PubMed  CAS  Google Scholar 

  32. Rubenstein A. H., Spitz I.: Role of the kidney in insulin metabolism and excretion — Diabetes17, 161, 1968.

    PubMed  CAS  Google Scholar 

  33. Schernthaner G., Stummvoll K. H., Muller M. M.: Glycosylated haemoglobin in chronic renal failure — Lanceti, 774, 1979.

    Article  Google Scholar 

  34. Spitz I. M., Rubenstein A. H., Bershon I., Abrahams C., Lowry C.: Carbohydrate metabolism in renal disease — Quart. J. Med.39, 201, 1970.

    PubMed  CAS  Google Scholar 

  35. Westervelt F. B., Schribner G. E.: The carbohydrate intolerance of uremic patients — Ann. intern. Med.57, 266, 1962.

    PubMed  CAS  Google Scholar 

  36. Westervelt F. B. Jr.: Insulin effect in uremia - J. Lab. clin. Med.74, 1969.

  37. Wide L., Axen R., Porath J.: Radioimmunosorbent assay of proteins. Chemical couplings of antibodies to insoluble dextran — Immunochemistry4, 381, 1967.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service de Médecine Interne, Département d’Endocrinologie-Diabète et Laboratoire, Hôpital Civil, Charleroi

    Jean C. Daubresse, François Dehout & Jean C. Meunier

  2. Département de Clinique et de Pathologie Médicales, Université de Liège, Liège

    Philippe Henrivaux

  3. Secteur de Diabétologie, Institut de Médecine, Université de Liège, Liège

    Alfred S. Luyckx & Pierre J. Lefebvre

Authors
  1. Jean C. Daubresse
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Philippe Henrivaux
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. François Dehout
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jean C. Meunier
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alfred S. Luyckx
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Pierre J. Lefebvre
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Daubresse, J.C., Henrivaux, P., Dehout, F. et al. B-cell response to a standardized breakfast in end-stage renal failure. Acta diabet. lat 22, 9–16 (1985). https://doi.org/10.1007/BF02591087

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02591087

Key-words

Search

Navigation