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[Pathogenetic relationships between obesity and maturity-onset diabetes]
Zeitschrift Fur Die Gesamte Innere Medizin Und Ihre Grenzgebiete
|June 1, 1977
Summary
Biguanide therapy improves glucose tolerance in obese diabetics by reducing insulin resistance. This is linked to reduced insulin levels and improved carbohydrate metabolism, potentially due to decreased lipocyte size.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Pharmacology
Background:
- Obesity and diabetes are linked to impaired glucose tolerance and altered insulin dynamics.
- Hypertrophic adipocytes in obese individuals may contribute to insulin resistance.
Purpose of the Study:
- To investigate the effects of biguanide therapy on glucose tolerance and insulin levels in obese diabetics.
- To compare biguanide therapy with sulfonylurea treatment regarding metabolic parameters.
- To assess insulin half-life and hormonal responses in obese diabetics undergoing treatment.
Main Methods:
- Comparative study of biguanide and sulfonylurea therapies.
- Measurement of immunoreactive insulin (IRI) levels, glucose tolerance, and fat parameters.
- Determination of insulin half-life before and after biguanide treatment.
- Tolbutamide test to examine insulin secretion, STH, and cortisol levels.
Main Results:
- Increased IRI levels in obese diabetics correlate with reduced carbohydrate tolerance and hypertrophic lipocytes.
- Hypertrophic fat cells require more insulin for glucose uptake.
- Weight reduction improves carbohydrate tolerance, likely due to decreased adipocyte size.
- Biguanide therapy demonstrated effects on glucose metabolism and insulin dynamics.
Conclusions:
- Hypertrophic lipocytes and reduced carbohydrate tolerance are key factors in obese diabetics.
- Biguanide therapy may improve glucose metabolism by influencing insulin requirements and adipocyte function.
- Understanding adipocyte behavior is crucial for managing metabolic disorders in obese diabetic patients.