Defective acute insulin secretion in diabetics. Differences between normal weight and obese subjects. 1978

P Vague, and G Ramahandridona, and B Vialettes, and J P Raymond, and J Vague

The acute insulin responses to intravenous glucose and tolbutamide were studied serially in middle aged subjects with a wide spectrum of glucose tolerance. Eighty were of normal weight, 102 frankly obese. In normal weight patients, insulin response to glucose, subnormal in chemical diabetes, was almost absent when fasting blood glucose was elevated. Tolbutamide evoked a normal response provided that the fasting blood glucose was lower than 125 mg/100 ml. The response decreased dramatically thereafter. In the obese the response decreased dramatically thereafter. In the obese the response to glucose was decreased in chemical diabetics compared to non-diabetics, but failed completely only when the fasting glycemia exceeded 200 mg/100 ml. The response to tolbutamide decreased only with fasting glycemia in excess of 200 mg/100 ml. When insulin responses were expressed relative to basal insulin values the differences between non diabetic obese and normal weight subjects disappeared but this was not true of the other categories. These findings demonstrate that the B-cell responses differ not only quantitatively but also in kind between normal weight and obese diabetics. Six cases of incipient juvenile diabetes (100 less than fasting blood glucose less than 125 mg/100 ml) showed no insulin response to glucose nor to tolbutamide in contrast to the comparable weight group of maturity onset diabetics.

UI MeSH Term Description Entries
D007328 Insulin A 51-amino acid pancreatic hormone that plays a major role in the regulation of glucose metabolism, directly by suppressing endogenous glucose production (GLYCOGENOLYSIS; GLUCONEOGENESIS) and indirectly by suppressing GLUCAGON secretion and LIPOLYSIS. Native insulin is a globular protein comprised of a zinc-coordinated hexamer. Each insulin monomer containing two chains, A (21 residues) and B (30 residues), linked by two disulfide bonds. Insulin is used as a drug to control insulin-dependent diabetes mellitus (DIABETES MELLITUS, TYPE 1). Iletin,Insulin A Chain,Insulin B Chain,Insulin, Regular,Novolin,Sodium Insulin,Soluble Insulin,Chain, Insulin B,Insulin, Sodium,Insulin, Soluble,Regular Insulin
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009765 Obesity A status with BODY WEIGHT that is grossly above the recommended standards, usually due to accumulation of excess FATS in the body. The standards may vary with age, sex, genetic or cultural background. In the BODY MASS INDEX, a BMI greater than 30.0 kg/m2 is considered obese, and a BMI greater than 40.0 kg/m2 is considered morbidly obese (MORBID OBESITY).
D001786 Blood Glucose Glucose in blood. Blood Sugar,Glucose, Blood,Sugar, Blood
D003920 Diabetes Mellitus A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.
D005947 Glucose A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. Dextrose,Anhydrous Dextrose,D-Glucose,Glucose Monohydrate,Glucose, (DL)-Isomer,Glucose, (alpha-D)-Isomer,Glucose, (beta-D)-Isomer,D Glucose,Dextrose, Anhydrous,Monohydrate, Glucose
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D014044 Tolbutamide A sulphonylurea hypoglycemic agent with actions and uses similar to those of CHLORPROPAMIDE. (From Martindale, The Extra Pharmacopoeia, 30th ed, p290) Apo-Tolbutamide,Artosin,Diabetol,Diaval,Dolipol,Orabet,Orinase,Rastinon,Tolbutamid R.A.N.

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