RETINAL STUDIES IN PATIENTS WITH HYPERGLYCAEMIA, HYPOINSULINAEMIA AND HYPERLIPIDAEMIA ASSOCIATED WITH HYPOPITUITARISM

1974 ◽  
Vol 75 (3) ◽  
pp. 503-513
Author(s):  
N. A. Samaan ◽  
S. G. Ouais
Keyword(s):  
Growth Hormone ◽  
Glucose Tolerance ◽  
Normal Subjects ◽  
Oral Glucose ◽  
Diabetic Patients ◽  
Insulinogenic Index ◽  
Oral Glucose Tolerance ◽  
Arginine Infusion ◽  
Family History Of Diabetes ◽  
History Of

ABSTRACT Twenty-four patients who had a 10-year history of hypopituitarism resulting from treated chromophobe adenoma, without known family history of diabetes, were studied during oral glucose tolerance (GTT), arginine infusion, and insulin tolerance (ITT) tests. All patients were receiving thyroid and cortisone replacement. Serum immunoreactive growth hormone (HGH) was subnormal in all patients compared with normal subjects during both arginine infusion and ITT tests (P < 0.001). Although 9 of this hypopituitary group were diabetic, all patients showed a subnormal peak immunoreactive insulin rise during an arginine infusion test and subnormal insulinogenic index during an oral glucose tolerance test, when compared with normal subjects in the same age range. Fasting plasma triglycerides were elevated in the majority of patients, serum cholesterol in 8 while free fatty acids were high in all patients. Hyperglycaemia, hypoinsulinaemia, hyperlipidaemia and low growth hormone levels were not associated with any of the clinical signs of vascular disease frequently seen in diabetic patients.

The Effect of Hypoglycaemia on Oral Glucose Tolerance in Normal Subjects and Patients with Pituitary and Adrenal Disorders

1970 ◽  
Vol 39 (5) ◽  
pp. 663-674 ◽  
Author(s):  
N. W. Oakley ◽  
H. S. Jacobs ◽  
R. C. Turner ◽  
J. Williams ◽  
C. Dos ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Glucose Tolerance ◽  
Normal Subjects ◽  
Growth Hormone Response ◽  
Saline Control ◽  
Oral Glucose ◽  
Hormone Response ◽  
Oral Glucose Tolerance ◽  
Brittle Diabetes ◽  
Insulin Test

1. Hypoglycaemia induces glucose intolerance in normal subjects—the ‘Somogyi effect’–and may be responsible for some instances of ‘brittle diabetes’. This effect may be mediated through the growth hormone response to hypoglycaemia, but other possible hormonal mechanisms have not been excluded. 2. Paired 2-h oral glucose tolerance tests have been carried out 2 h after both (a) i.v. saline (control day) and (b) i.v. insulin (test day) in four normal subjects and twenty-seven patients with pituitary and adrenal under- and over-activity. Plasma glucose, insulin, Cortisol and growth hormone have been estimated at half-hourly intervals during the 4 h of each study. 3. A significant Somogyi effect is usually seen only when there is a growth hormone response to insulin-induced hypoglycaemia; hypopituitary subjects do not show the effect. 4. There is a correlation between the extent of the Somogyi effect and the growth hormone response to insulin, using a simple derived index to represent each function (P < 0·05). 5. Insulin secretion in normal subjects tends to be higher on the test than the control day, making inhibition of insulin release an unlikely primary mechanism. 6. The presence or absence of a Somogyi effect could not be related to insulin-induced changes in plasma Cortisol values. 7. Examination of individual cases supports the view that, while growth hormone may be mainly reponsible for the Somogyi effect, yet it is sometimes difficult to explain the effect without invoking other endocrine mechanisms.

Family History of Diabetes Mellitus and Oral Glucose Tolerance Testing Criteria

1987 ◽  
Vol 66 (6) ◽  
pp. 489-492 ◽  
Author(s):  
Joanne Piscitelli ◽  
Robert D. Eden ◽  
Frederick R. Jelovsek ◽  
Arnold S. Grandis ◽  
Stanley A. Gall
Keyword(s):  
Diabetes Mellitus ◽  
Family History ◽  
Glucose Tolerance ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Oral Glucose Tolerance Testing ◽  
Family History Of Diabetes ◽  
History Of ◽  
Testing Criteria ◽  
Tolerance Testing

Glucose Tolerance in Depression

1968 ◽  
Vol 114 (510) ◽  
pp. 627-630 ◽  
Author(s):  
Brenda Herzberg ◽  
Alec Coppen ◽  
Vincent Marks
Keyword(s):  
Glucose Tolerance ◽  
Severe Depression ◽  
Normal Subjects ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Diabetic Patients ◽  
Extensive Literature ◽  
Oral Glucose Tolerance ◽  
Intravenous Glucose ◽  
Glucose Tolerance Tests

There have been many reports which suggest that there may be abnormal glucose metabolism in severe depression. Glycosuria was first reported nearly 60 years ago (Allers, 1914). In 1919, using an oral glucose tolerance test, Kooy observed decreased tolerance in a heterogeneous group of mentally ill patients which included melancholics. Since then many investigators have reported decreased glucose tolerance in depressive illness, and the extensive literature is reviewed by McFarland and Goldstein (1939) and Altschule (1953). Oral glucose tolerance tests have usually shown high or delayed peaks and a slow return to fasting levels, although the latter are usually reported normal. Intravenous glucose tolerance tests have also shown results nearer those obtained in diabetic patients than in normal subjects. Pryce (1958) reported decreased glucose tolerance with intravenous tests in a sample of 20 depressed patients, and he also found that glucose tolerance did not alter significantly after clinical recovery. Glucose supplements were added to the diet of six patients prior to testing, but he concluded that these supplements did not appear to alter glucose tolerance.

Relationship between oral glucose tolerance and insulin sensitivity in healthy man and type 1 diabetic patients

1986 ◽  
Vol 112 (3) ◽  
pp. 355-360 ◽  
Author(s):  
Hannele Yki-Järvinen ◽  
Eero Helve ◽  
Veikko A. Koivisto
Keyword(s):  
Insulin Sensitivity ◽  
Glucose Metabolism ◽  
Glucose Tolerance ◽  
Normal Subjects ◽  
Oral Glucose ◽  
Diabetic Patients ◽  
Oral Glucose Tolerance ◽  
Healthy Man ◽  
Type 1 Diabetic Patients

Abstract. The relationship between insulin sensitivity and oral glucose tolerance was studied in 8 conventionally treated type 1 diabetic patients (age 34 ± 4 years, relative body weight (RBW) 113 ± 5%) and in 11 healthy subjects (age 35 ± 3 years, RBW 114 ± 2%). In each subject and patient, oral glucose tolerance (75 g glucose) and in vivo sensitivity to insulin (euglycaemic clamp technique, 1 mU/kg/min insulin infusion) were measured. The response to oral glucose in the diabetic patients was measured during maintenance of similar peripheral plasma free insulin levels as in the normal subjects during the oral glucose tolerance test (OGTT). During the OGTT, the post-glucose plasma glucose values in the diabetic patients were markedly higher (P < 0.001) than in the normal subjects. During the clamp study, the rate of glucose metabolism in the diabetic patients (4.53 ± 0.58 mg/kg/min) was 37% lower than in the normal subjects (7.19 ± 0.67 mg/kg/min, P < 0.02). The area under the glucose curve was inversely related to the rate of glucose metabolism in both the diabetic (r = −0.72, P < 0.02) and the normal (r = −0.69, P < 0.02) subjects. The slope of the curve was substantially steeper in the diabetic than the control subjects. Thus, peripheral insulin sensitivity contributes to oral glucose tolerance both in healthy man, and even to a greater extent, in type 1 diabetic patients.

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