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Effects of oral glucose on systemic glucose metabolism during hyperinsulinemic hypoglycemia in normal man

P L Poulsen1, L Orskov, T Grøfte

  • 1Medical Department M (Diabetes and Endocrinology), Aarhus, Kommunehospital, Denmark.

Metabolism: Clinical and Experimental
|January 6, 2001
PubMed

Insights

Oral glucose rapidly impacts systemic glucose metabolism within 5-10 minutes during hypoglycemia, with noticeable effects around 40 minutes. This study clarifies the timing and magnitude of oral glucose

Area of Science:

  • Endocrinology
  • Metabolic Science

Background:

  • Oral glucose is widely used for hypoglycemia treatment, but its precise systemic effects and timing are poorly understood.
  • Empirical use of oral glucose lacks detailed data on its absorption kinetics and metabolic impact during hypoglycemic states.

Purpose of the Study:

  • To define the systemic impact and time course of effects following oral glucose administration during induced hypoglycemia.
  • To quantify the rapid metabolic responses to oral glucose compared to clamped hypoglycemia.

Main Methods:

  • Seven healthy men underwent two 6-hour hyperinsulinemic-hypoglycemic clamp studies.
  • Oral glucose (40g) with 3-ortho-methylglucose (3-OMG) was administered in one trial; the other served as a control without oral glucose.
  • Plasma glucose, insulin, C-peptide, glucagon, growth hormone (GH), and glucagon-like peptide-1 (GLP-1) were measured; glucose infusion rates (GIRs) and glucose turnover were assessed.

Main Results:

  • Oral glucose intake led to significantly lower GIRs starting within 5-10 minutes, becoming significant at 20 minutes and peaking at 40 minutes.
  • Absorption of oral glucose was confirmed by a rise in 3-OMG levels after 20 minutes.
  • Oral glucose ingestion stimulated increases in serum C-peptide and GLP-1, which were not observed in the control condition.

Conclusions:

  • Oral glucose exerts rapid effects on systemic glucose metabolism, observable within 5-10 minutes of ingestion during hypoglycemia.
  • The immediate metabolic impact of oral glucose is modest, with a more pronounced effect observed around 40 minutes.
  • Further research into oral therapeutic agents with faster onset of action is warranted for hypoglycemia management.

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