Combined insulin-sulfonylurea therapy leads to modest improvement in glycemic control compared with insulin therapy alone. With combined therapy, lower insulin doses may be used to achieve similar control. Obese patients with higher fasting C-peptides may be more likely to respond than others.

No abstract

Plasma triglycerides (neutral fat) may be divided into 1) that portion which is present during the fasting state and 2) that which, after ingestion of fat, is added to and temporarily augments the fasting level of triglycerides.The present investigation deals with the relationship of plasma free fatty acids (plasma FFA) to fasting plasma triglycerides (plasma TG) in man. From these observations a quantitative assessment of the amount of plasma FFA converted to plasma TG will be presented. The data also permit calculations which suggest that plasma FFA may be the major source of fasting plasma TG. METHODSTwo types of studies were carried out in male patients without known abnormalities of fat metabolism.1. Non-reinjection experiments. After an overnight fast of 15 hours, 9 subjects were given 0.004 to 0.008 mc albumin-bound palmitic acid-i-C1' intravenously either by single injection or by 2-hour constant infusion. Two individuals received 0.00585 mc of albumin-bound oleic acid-i-C1' and another 0.00597 mc of stearic acid-1-C14.During the day of the study the subjects were permitted no breakfast, a nonfat lunch, and an unrestricted supper. Venous blood samples were drawn at appropriate intervals over a period of 24 hours after administration of fatty acid C1' for determination of neutral fat activity. Two-ml aliquots of plasma were extracted by the method of Dole (1). Eight ml of the upper phase, representing 1.85 ml of plasma, was transferred to a separate tube. Ten ml of 0.1 N NaOH in 50 per cent ethanol was added, according to the method of Borgstrbm (2), in order to * This investigation was supported in part by a grant from the Life Insurance Medical Research Fund; by a research grant H-4807; a training grant, HTS-5369, from the National Heart Institute, Public Health Service; a research grant, A-4535-MET, from the National Institutes of Health, Public Health Service; a research grant for July 1960-61, from the North Carolina Heart Association; and by the Regional Center for the Study of Aging, Duke University. remove fatty acids from the upper phase. The upper phase and its contents were then transferred quantitatively to liquid scintillator vials, dried with a stream of warm air from a hair dryer, and redissolved in 5 ml of phosphor solution for counting in a Packard Tri-Carb liquid scintillation spectrometer. Along with plasma glycerides, the extracts contained cholesterol, cholesterol esters and a small amount of phospholipid. These would also be expected to become labeled; therefore, it was necessary to determine the amount of activity in the various plasma lipids present in the extracts at various times after injection of C4-labeled fatty acids. This was done by means of silicic acid chromatography using the method of Hirsch and Ahrens (3) without modification. Plasma palmitic acid-l-C1 activity was measured as previously described (4).The experimental plan required a method which would permit easy and reproducible determinations on a large number of samples. The method selected for measuring plasma T...

No abstract

No abstract