Effects of type 2 diabetes on the regulation of hepatic glucose metabolism

被引:36
作者
Basu, A
Shah, P
Nielsen, M
Basu, R
Rizza, RA
机构
[1] Mayo Clin & Mayo Fdn, Dept Endocrinol, Rochester, MN 55905 USA
[2] Aarhus Univ Hosp, Dept Surg, Aarhus, Denmark
关键词
glucose production; hepatic insulin action; glucagon; glucose effectiveness;
D O I
10.1136/jim-52-06-30
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Glucose production is inappropriately increased in people with type 2 diabetes both before and after food ingestion. Excessive postprandial glucose production occurs in the presence of decreased and delayed insulin secretion and lack of suppression of glucagon release. These abnormalities in hormone secretion, coupled with impaired insulin-induced suppression of glucose production and stimulation of splanchnic glucose uptake, likely account in large part for the excessive amounts of glucose that reach the systemic circulation for disposal by peripheral tissues following food ingestion. In contrast, when adequate basal insulin concentrations are present, neither glucagon-induced stimulation of glucose production nor glucose-induced suppression of glucose production differs in diabetic and nondiabetic subjects matched for gender, age, and degree of obesity. However, when insulin secretion is defective, lack of suppression of glucagon can cause substantial hyperglycemia by enhancing rates of glucose production. Therefore, normalization of hepatic glucose metabolism in people with type 2 diabetes mellitus likely will require normalization of insulin and glucagon secretion as well as hepatic insulin action.
引用
收藏
页码:366 / 374
页数:9
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