The plasma insulin responses of normal weight and obese, diabetic, and nondiabetic subjects to intravenous glucose was only 30-40% of that seen after oral glucose, indicating that alimentary mechanism(s) in addition to the arterial blood sugar concentration regulate insulin secretion. Observations made in subjects with diverted portal circulation indicate that the alimentary insulinogenic mechanism is located in the intestinal tract. The insulinogenic potency of the alimentary and glycemic stimuli expressed in terms of insulin secretion per gram of glucose were remarkably similar within each group of individuals. Between these groups, however, there were considerable differences. Obesity, with or without associated diabetes, was associated with a true hypersecretory responsiveness, whereas diabetes was characterized, with or without obesity, by a marked impairment in insulin secretion. The experimental design used in these studies permitted quantitation of the magnitude of the glycemic component of an oral glucose load. As a consequence of impaired insulin secretion, a greater than normal proportion of the oral glucose load escapes initial hepatic extraction in the maturity-onset diabetic and enters the peripheral circulation. Therefore, in the noninsulin-requiring maturity-onset diabetic, the glycemic insulinogenic stimulus for a given oral glucose load is significantly greater than in normal subjects and accounts for the excessive plasma insulin responses observed late in the course of an oral glucose tolerance test.
Michael J. Perley, David M. Kipnis
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Title and authors | Publication | Year |
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Physiology and Emerging Biochemistry of the Glucagon-Like Peptide-1 Receptor
FS Willard, KW Sloop |
Experimental Diabetes Research | 2012 |
Steroid-induced insulin resistance and impaired glucose tolerance are both associated with a progressive decline of incretin effect in first-degree relatives of patients with type 2 diabetes
DH Jensen, K Aaboe, JE Henriksen, A Vølund, JJ Holst, S Madsbad, T Krarup |
Diabetologia | 2012 |
Incretins as a novel therapeutic strategy in patients with diabetes and heart failure
MA Khan, C Deaton, MK Rutter, L Neyses, MA Mamas |
Heart Failure Reviews | 2012 |
Incretin-based therapies
AH Stonehouse, T Darsow, DG Maggs |
Journal of Diabetes | 2012 |
Uncoupling protein 2 negatively regulates glucose-induced glucagon-like peptide 1 secretion
H Zhang, J Li, X Liang, Y Luo, K Zen, CY Zhang |
Journal of Molecular Endocrinology | 2012 |
Acute and chronic administration of SHR117887, a novel and specific dipeptidyl peptidase-4 inhibitor, improves metabolic control in diabetic rodent models
X Liu, L Zhang, Y Feng, L Zhang, H Qu, G Cao, Y Leng |
Acta Pharmacologica Sinica | 2012 |
Synergism by individual macronutrients explains the marked early GLP-1 and islet hormone responses to mixed meal challenge in mice
L Ahlkvist, J Vikman, G Pacini, B Ahrén |
Regulatory Peptides | 2012 |
Comparative Clinical Pharmacokinetics of Dipeptidyl Peptidase-4 Inhibitors:
LK Golightly, CC Drayna, MT McDermott |
Clinical Pharmacokinetics | 2012 |
Comparative Clinical Pharmacokinetics of Dipeptidyl Peptidase-4 Inhibitors
LK Golightly, CC Drayna, MT McDermott |
Clinical Pharmacokinetics | 2012 |
Elucidation of the function and role of cAMP sensor Epac2A in insulin secretion
T Shibasaki |
Diabetology International | 2012 |
Expression profiling identifies novel gene targets and functions for Pdx1 in the duodenum of mature mice
C Chen, E Sibley |
AJP Gastrointestinal and Liver Physiology | 2012 |
Slowly and rapidly digestible starchy foods can elicit a similar glycemic response because of differential tissue glucose uptake in healthy men
C Eelderink, M Schepers, T Preston, RJ Vonk, L Oudhuis, MG Priebe |
The American journal of clinical nutrition | 2012 |
Doves, Diplomats, and Diabetes
M Watve |
2012 | |
Chronobiology and Obesity
M Garaulet, JM Ordovás |
2012 | |
Principles of Metabolic Surgery
WK Karcz, O Thomusch |
2012 | |
Incretins and their influence on the course of type 2 diabetes in patients with morbid obesity after bariatric oper
II Dedov, YI Yashkov, EV Ershova |
Obesity and metabolism | 2012 |