GLUCOSE TOLERANCE, FREE FATTY ACID, AND SERUM INSULIN RESPONSES IN PATIENTS WITH CIRRHOSIS

The blood glucose, free fatty acids, and serum insulin responses to a 75-g oral glucose load were studied in 25 cirrhotic patients and the results compared with those obtained in 25 normal control subjects. Twenty-two of the patients with cirrhosis had impaired glucose tolerance. This was associated with elevated free fatty acid levels in 17 instances. Two additional patients had increased free fatty acids with normal glucose tolerance. Hyperinsulinemia was demonstrated in each patient with liver disease, including the 3 with normal glucose tolerance. Although the exact mechanism for the increased insulin response to glucose is not clear, the concurrence of hyperglycemia and hyperinsulinemia is best explained by insulin resistance. The elevated free fatty acids present in most of these patients may contribute to this insulin insensitivity. © 1969 Hoeber Medical Division • Harper & Row, Publishers, Incorporated.