Studies on the Kinetics of Glucose Utilization

Hlad, C. J.; Elrick, Harold; Witten, Thomas A.; Smith, A.; Arai, Y.; Bow, Ted M.

doi:10.1172/jci103368

Cited by 38 publications

(22 citation statements)

References 14 publications

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“…The synthesis of six or more points into a single value characterizing tolerance is more logical for comparative studies than one or more single values at specific times. Whether K should be calculated from total hexose values, or from the increments above the fasting value has also led to much discussion and elaboration (31)(32)(33) without any clear evidence of practical or theoretical superiority of either method. There is some suggestion (33) that the disappearance rate of the absolute glucose level is better related to glucose utilization than the disappearance of increment blood glucose.…”

Section: Discussionmentioning

confidence: 99%

Mannose Utilization in Man*

Wood¹,

Cahill²

1963

J. Clin. Invest.

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Section: Discussionmentioning

confidence: 99%

Mannose Utilization in Man*

Wood¹,

Cahill²

1963

J. Clin. Invest.

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“…This assumption may be applied safely only to the early parts of the curve, since it is obvious that alterations in the glucose concentration will be introduced by other processes in the body which tend to add glucose to the circulation, particularly when blood sugar levels fall to low values, as in the case when insulin is administered. Greville (50) as well as Hlad, Elrick, and Witten (32) found that subtraction of a calculated asymptotic value of blood sugar level resulted in a somewhat better fit to glucose tolerance data beyond 90 minutes. In this study where curves were limited to the first 60 minutes, the fit was very good; the introduction of an asymptote had only a small insignificant effect on goodness of fit.…”

Section: The Tolerance Equationmentioning

confidence: 98%

Age Differences in the Intravenous Glucose Tolerance Tests and the Response to Insulin

Silverstone¹,

Brandfonbrener²,

Shock³

et al. 1957

J. Clin. Invest.

130

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In addition to providing information with regard to the status of carbohydrate metabolism, the time course of the disappearance of injected glucose from the blood stream offers information concerning the overall effectiveness of a variety of physiological mechanisms involved in maintaining homeostasis. In a number of investigations, reduction in glucose tolerance, i.e., a slower rate of return to fasting levels of blood sugar following the oral (1-17) or intravenous (18)(19)(20) administration of glucose, has been reported in older people. The diminished glucose tolerance in the older individual might be due to: (a) inadequate release of insulin from the pancreas, or greater inactivation of endogenously released insulin, (b) the loss of functioning protoplasm with increasing age so that less metabolizing tissue is removing glucose from the blood, (c) a diminution in the effectiveness of the metabolic processes involved in the removal of sugar from the blood stream, (d) alterations in the rate of release of glucose from the liver, or (e) a reduction in the volume in which the glucose is originally distributed in the aged. By comparing the glucose and glucose-insulin tolerance tests in the same individual, an estimate of the effect of insulin may be obtained (21)(22)(23)(24)(25)(26)(27). In the experiments to be reported, standard amounts of insulin were administered along with glucose to both old and young subjects with the aim of investigating age differences in the response to the insulin. Table I. Experimental procedure. The intravenous glucose tolerance test (GTT) and the glucose-insulin tolerance test (GITT) were performed in each subject under basal conditions and separated by an interval of not less than one week. In 8 of the subjects, each of the tests (GTT and GITT) was carried out twice in order to evaluate reliability.Twenty minutes before either test was begun, a modified Lindeman needle was placed in an antecubital vein and left in place for the duration of the test. The needle was kept patent by heparinization of the stylus and was used subsequently only for withdrawing blood specimens without a tourniquet (29). A vein in the opposite arm was used for the injection of 50 ml. of 50 per cent glucose in water over a period of two minutes. For the GITT, 5 units of hyperglycemic factor-free insulin8 (Lilly), per square meter of body surface area, were rapidly injected, followed immediately by the standard amount of glucose. The fasting blood specimen was obtained through the Lindeman needle a few minutes before zero time, which was recorded as the beginning of the injection of glucose.Blood samples were collected at 5-minute intervals for the first hour and at 20-minute intervals during the second hour, and were placed immediately in tubes containing a dried heparin and sodium fluoride mixture. All analyses were completed the day of the test, using the Nelson-Somogyi method (30). Determinations were in duplicate and were read on a Model DU Beckman Spectrophotometer.Data analysis. For each tolerance test...

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“…F OR many years attempts have been made to replace oral glucose tolerance tests with intravenous techniques so as to eliminate the variable of intestinal absorption and to obtain a more quantitative index of carbohydrate metabolism (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Intravenous methods permit the calculation of a specific rate constant for glucose utilization (K) from a relationship of blood glucose and time.…”

mentioning

confidence: 99%

“…Amatuzio et al (4) Lozner et al (5) Bastenie et al (6) Marks & Bishop (7) Silverstone et al (8) Greville (9) Holten et al (10) Hlad et al (11) Jokipii & Turpeinen (12) No Hamilton and Stein (13) introduced a simple exponential equation 2 to describe blood glucose disappearance: 2 Definition of symbols: C g -Blood glucose concentration at any time (t). Cj-Fasting level of blood glucose.…”

mentioning

confidence: 99%

“…In a previous study we showed that it was not necessary to assume a first-order reaction (11). Instead, experimentally established relationships between blood glucose concentration and peripheral and hepatic glucose utilization reported by others (14)(15)(16)(17)(18) were used to derive equations which more accurately described blood glucose disappearance for extended experimental periods.…”

mentioning

confidence: 99%

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Further Studies of the Kinetics of Glucose Utilization. I. A New Method of Data Analysis*

Hlad¹,

Elrick²,

Arai³

1959

The Journal of Clinical Endocrinology & Metabolism

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Evidence is presented to show that the extreme variation in rate constants for blood glucose disappearance reported by different laboratories is due to the use of an incorrect equation and/or an incorrect method of data analysis. It is demonstrated that graphic (semi-log) methods are too insensitive to be used to justify equations describing blood glucose disappearance. The correct equation is shown to be one of exponential form containing an added constant term which in the normal subject is significantly less than the fasting level of blood glucose. A new method of data analysis (slope analysis) is described which results in the same specific rate constant, K, regardless of the equation employed. This method is made practical by the introduction of a mechanical slope reader which eliminates excessive calculations.

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Studies on the Kinetics of Glucose Utilization

Cited by 38 publications

References 14 publications

Mannose Utilization in Man*

Mannose Utilization in Man*

Age Differences in the Intravenous Glucose Tolerance Tests and the Response to Insulin

Further Studies of the Kinetics of Glucose Utilization. I. A New Method of Data Analysis*

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