Glucose Turnover Rate and Peripheral Insulin Sensitivity in Alcoholic Patients without Liver Damage

Abstract

Glucose intolerance is frequently found in alcoholic patients and an impaired insulin response has been documented in them. To look for alternative mechanisms that could explain this intolerance, a glucose turnover using tritiated glucose and an euglycemic glucose clamp were performed to measure the glucose production rate and peripheral insulin sensitivity, respectively. Two groups of recently abstinent chronic male alcoholic patients without evidence of liver damage were studied. The glucose turnover technique showed a higher basal glucose production rate in alcoholics, compared with normal volunteers (2.83 ± 0.29 vs. 1.84 ± 0.22 mg/kg/min); an intravenous ethanol load significantly increased this rate. The euglycemic glucose clamp did not show peripheral insulin resistance in alcoholics, compared with controls.

Intergenerational effects of prenatal ethanol on glucose tolerance and insulin response

“…Human chronic alcoholics are predominantly hyperglycemic even when abstinent, although some cases present with hypoglycemia (5,6,24). These findings extend to rodents, where some, but not all, studies show hyperglycemia with chronic alcohol consumption (23,27).…”

Metabolic effects of alcohol on skeletal muscle

“…Some studies identify reduced insulin levels (Iturriaga et al, 1986), possibly due to increased hepatic insulin extraction (Piccardo et al, 1994) as the factor underlying the glucose intolerance, whereas other studies ascribe the intolerance to peripheral insulin resistance (Hed et al, 1977;Adner & Nygren, 1990). Short-term abstinence is also reportedly associated with increases in basal net glucose production, without any accompanying peripheral insulin resistance (Bunout et al, 1989). Longer-term ( Ͼ 7 days) abstinence is associated with increases in forearm glucose uptake, the contribution made by muscle to whole-body glucose disposal being increased two-fold (Hed et al, 1977), although other reports indicate that abstinent alcoholics show hyperinsulinaemia and increased C-peptide levels consistent with insulin resistance (Anderson et al, 1983).…”

Ethanol

“…624,625 More serious is episodic hypoglycemia (Table 12- 19), which tends to occur after 6 to 36 hours of moderate to heavy drinking, albeit infrequently; a blood glucose level below 50 mg/dL was found in only one of 131 intoxicated subjects. 624,625 More serious is episodic hypoglycemia (Table 12- 19), which tends to occur after 6 to 36 hours of moderate to heavy drinking, albeit infrequently; a blood glucose level below 50 mg/dL was found in only one of 131 intoxicated subjects.…”