To analyze the effects of short-term fasting on postprandial glucose metabolism in non-insulin-dependent diabetes mellitus (NIDDM), two groups of nine obese NIDDM patients and two comparable groups of control subjects underwent a 5-h oral glucose tolerance test after either 14 h or 4 days of fasting. The fluxes and the rates of oxidation and storage of glucose were measured using a dual isotope technique combined with indirect calorimetry. The effect of fasting on insulin action and beta-cell responsiveness was tested in an additional group of six obese NIDDM patients with a euglycemic hyperinsulinemic clamp followed by an intravenous glucagon test. In the diabetic patients, fasting enhanced beta-cell response to glucose and glucagon and did not modify insulin action. This response differs from that of nondiabetic subjects in whom fasting is known to impair insulin secretion and action. Regarding glucose fluxes, it was observed that in the overnight-fasted state, the incremental tissular disposal following glucose ingestion was reduced by ∼ 50% in the diabetic versus control subjects in relation to an ∼ 62% impairment in glucose storage. After fasting, incremental tissular disposal was restored to normal, glucose oxidation was virtually abolished, and storage was increased ∼ threefold. Thus, in NIDDM patients, fasting corrects the defect in glycogen storage without modifying the action of insulin on glucose uptake and improves beta-cell responsiveness, the latter two effects being opposite to those observed in nondiabetic subjects.
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Original Articles| December 01 1994
Glucose Metabolism During the Starved-To-Fed Transition in Obese Patients With NIDDM
Address correspondence and reprint requests to Dr. Francoise Fery, Laboratory of Experimental Medicine, CPI 618, Faculty of Medicine, University of Brussels, 808 Route de Lennik, B-1070 Brussels, Belgium.
Françhise Féry, Edmond O Balasse; Glucose Metabolism During the Starved-To-Fed Transition in Obese Patients With NIDDM. Diabetes 1 December 1994; 43 (12): 1418–1425. https://doi.org/10.2337/diab.43.12.1418
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