Influence of Thyroid Function on Carbohydrate Metabolism and a New Method for Assessing Response to Insulin

Elrick, Harold; Hlad, C. J.; Arai, Y.

doi:10.1210/jcem-21-4-387

Cited by 58 publications

(10 citation statements)

References 29 publications

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“…treatment was 1-03 ± 0-42, and after treatment 0-89 ± 0-27, (P > 0-05). This indicates that in the hypothyroid state the body is no less efficient in disposing of glucose per unit of insulin than when euthyroid, and does not support the concept of insulin resistance in hypothyroidism reported by Elrick, Hlad & Arai (1961), although two out of the four diabetic curves in our patients reverted to normal with thyroxine therapy. The significantly higher insulin secretion in the first 60 min.…”

contrasting

confidence: 97%

The Effect of Hypothyroidism on Glucose Tolerance and Insulin Metabolism

Jackson¹,

Prentice²,

McKiddie³

1970

Journal of Endocrinology

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contrasting

confidence: 97%

The Effect of Hypothyroidism on Glucose Tolerance and Insulin Metabolism

Jackson¹,

Prentice²,

McKiddie³

1970

Journal of Endocrinology

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“…Because exogenous insulin increases K values (19), it would be expected that the K value following oral glucose would exceed that following intravenous glucose. However, the increase in insulin concentrations observed in the present studies (2-or 3-fold) was much less than that (10-fold) obtained in the experiments in which 3 units of insulin were administered intravenously (19; Stimmler, L., and H. Elrick, unpublished data).…”

Section: Discussionmentioning

confidence: 99%

Plasma Insulin Response to Oral and Intravenous Glucose Administration1

Elrick¹,

Stimmler²,

Hlad³

et al. 1964

The Journal of Clinical Endocrinology & Metabolism

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756

325

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This paper describes a new method for evaluating glucose metabolism in man using an oral glucose load. The procedure permits the calculation of a blood glucose disappearance rate constant (K) and thereby makes it possible to compare quantitatively the response to oral and intravenous glucose administration in a given individual. Ten metabolically normal adult humans were studied under carefully controlled conditions. Each received similar amounts (20 g) of glucose both orally and intravenously (2-7 days apart) by constant infusion for 1 hr. The effects on blood glucose disappearance rate constants (K) and plasma insulin concentrations (immunoassay) during and for 1 hr following the infusion were compared. Blood glucose concentrations and K values with the 2 routes of glucose administration were similar. In contrast, plasma insulin responses showed a significant difference: oral glucose resulted in a significant and sustained rise, whereas intravenous glucose was associated with a smaller and transient increase.The plasma insulin increase with intravenous glucose is considered to be due to the wellknown effect of hyperglycemia on insulin secretion. The greater and more sustained increase in plasma insulin with oral glucose is interpreted as evidence for an additional stimulus to insulin secretion, possibly a gastrointestinal or liver factor triggered by alimentary glucose. (J Clin Endocr 24: 1076, 1964 B OTH ORAL and intravenous glucose tolerance tests are widely used to evaluate glucose metabolism in man. Intravenous methods permit the calculation of a specific rate constant for glucose utilization (K) from a relationship of blood glucose and time, whereas present oral methods do not allow for such a quantitative expression of data and are handicapped by the variable of intestinal absorption. Thus, there are no published reports on a quantitative comparison of oral and intravenous glucose utilization in man.This paper describes a new method for

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“…Moreover, studies with intravenous glucose tolerance tests have revealed an increased glucose utilization in hyperthyroidism and a decreased utilization in hypothyroidism [12,21]; therefore, the abnormalities in oral glucose tolerance tests in hyperthyroidism cited above are probably the expression of the increased rate of glucose absorption from the gut [1]. Increased glucose utilization has also been observed in hyperthyroid rats and in their adipose tissue in vitro [26,23,13]; it has also been postulated for human adipose tissue in hyperthyroidism [6].…”

Section: Insulinspiegel Beimentioning

confidence: 99%

Insulin levels in thyrotoxicosis and primary myxoedema: Response to intravenous glucose and glucagon

et al. 1970

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Summary. Glucose disappearance, insulin-like activity (ILA) and serum immunoreaetive insulin (Ii%I) were studied after intravenous injection of glucose or glueagon in patients suffering from thyrotoxieosis or primary myxoedema. A group of normal subjects was also investigated. Glucose disappearance rate appeared to be normal in hyperthyroid, and markedly reduced in hypothyroid subjects. Fasting ILA levels were significantly higher than normal in myxoedema, and lower than normal in thyrotoxicosis. On the other hand, fasting I1:r levels were higher than normal in myxoedema but normal in thyrotoxieosis. After glucose administration I LA in myxoedema remained at higher values than in thyrotoxieosis at any time of the study; in myxoedema, peak ILA levels were reached later than in thyrotoxieosis ; peak I1%1 levels of similar magnitude were reached slightly earlier than normal in thyrotoxicosis, and later in myxoedema; in the latter condition, elevated IgI levels were observed for a longer period than in either euthyroidism or hyperthyroidism. During this test the insulingogenic index showed only slight changes in normal and in thyrotoxie subjects, whereas it increased significantly up to 60 rain in myxoedema. The data indicate that the reduced glucose utilization in hypothyroidism is not due to insulin deficiency, but rather to insulin resistance. It also seems possible that thyroid function influences the time of maximal insulin response to intravenous glucose administration. After glueagon injection, the increase in blood glucose was lower and shorter than normal in thyrotoxieosis; it was initially somewhat slower, but later higher and more sustained than normM, in myxoedema. The smaller increment in blood glucose in the former condition is probably eormeeted with reduced glycogen stores. ILA response was very high and well sustained in myxoedema, whereas it was moderate and shortlasting in thyrotoxieosis. Ii%I response was higher than normal in hypothyroid subjects, and lower than normal in thyrotoxie subjects. No difference in the time required for maximal response was observed among the three groups.

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Influence of Thyroid Function on Carbohydrate Metabolism and a New Method for Assessing Response to Insulin

Cited by 58 publications

References 29 publications

The Effect of Hypothyroidism on Glucose Tolerance and Insulin Metabolism

The Effect of Hypothyroidism on Glucose Tolerance and Insulin Metabolism

Plasma Insulin Response to Oral and Intravenous Glucose Administration1

Insulin levels in thyrotoxicosis and primary myxoedema: Response to intravenous glucose and glucagon

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