Vagal Stimulation of Gastric Secretion in Man by 2-Deoxy-D-Glucose

“…In more than 100 reported 2DG tests (50 mg/kg) in normal adult subjects, the average increase of plasma glucose has been approximately 90 mg/dl (1,7,13,23,25,36,38,39,40). The lowest increase reported among 18 individual normal adult subjects was 26 mg/dl (23,38,39).…”

Section: Discussionmentioning

confidence: 99%

“…The major disadvantage of using 2DG at present is that it is not readily available for human use and is likely to remain an investigational drug for the foreseeable future because of lack of demand. Although investigational experience with 2DG has been greater in adults, practical applications for diagnostic use in adults remain limited, including testing intactness of the vasogastric (7,13) and sympathoadrenal reflexes (1,38). In summary, the 2DG test provides a useful supplement to fasting as a diagnostic tool for detection and confirmation of hypoglycemia in childhood.…”

Section: Discussionmentioning

confidence: 99%

“…The hyperglycemic response is the result of central inhibition of glucose transport in the hypothalamus (27). This results in acute sympathoadrenal (1,16,23,25,38), anterior pituitary (1, 25, 39), vagal (7,13), and appetite responses (7,23,24,34,38) that are similar to those produced by insulin without the superimposed peripheral effects of insulin. The normal counter-regulatory response includes increases in plasma glucose, free fatty acids, lactate, epinephrine, cortisol, and suppression of insulin (1,23,25,38).…”

Section: Abbreviationmentioning

confidence: 99%

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The 2-Deoxyglucose Test as a Supplement to Fasting for Detection of Childhood Hypoglycemia

1984

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Summaryhvvodvcemic, it is inevitably dificult and not without risk.The acute response to simulated hypoglycemia induced by 2-deoxyglucose (2DG) was compared with the prolonged fasting test as a possible screening test for detection of childhood hypoglycemia. Ten children, ages 2-9 yr, without a documented history of hypoglycemia were classified retrospectively as reference subjects. While fasting, their plasma glucose decreased to an average of 50 mg/dl (range, 30-74) between 28-36 h. After infusion of 2DG, 50 mg/kg IV over 30 min, their plasma glucose increased by an average of 35 mg/dl (range, 19-56) between 60-120 min. The half-life of plasma 2DG was 48 min.Twenty-three other children in the same age range had an abnormal response to one or both of these tests. Thirteen of these children became definitely hypoglycemic while fasting (glucose < 30 mg/dl) and also failed to increase their plasma glucose by more than 10 mg/dl after 2DG. Five children had plasma glucose values between 30-40 mg/dl during the first 24 h of fasting that were associated with a change in mental status but responded to 2DC with an increase in plasma glucose. The remaining five subjects had an apparently normal response to fasting but did not respond to 2DG; two of these had documented spontaneous hypoglycemia. No cases of documented hypoglycemia were undetected by either test. It is concluded that the 2DG test is a short safe supplement to fasting which is equally effective as the prolonged fasting test in detecting hypoglycemia. Neither test alone is completely reliable, but the combination is complementary. Abbreviation

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“…The hyperglycemic response is the result of central inhibition of glucose transport in the hypothalamus (27). This results in acute sympathoadrenal (1,16,23,25,38), anterior pituitary (1, 25, 39), vagal (7, 13), and appetite responses (7,23,24,34,38) that are similar to those produced by insulin without the superimposed peripheral effects of insulin. The normal counter-regulatory response includes increases in plasma glucose, free fatty acids, lactate, epinephrine, cortisol, and suppression of insulin (1,23,25,38).…”

mentioning

confidence: 99%

The 2-Deoxyglucose Test as a Supplement to Fasting for Detection of Childhood Hypoglycemia

1984

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Summaryhvvodycemic, it is inevitably difficult and not without risk.The acute response to simulated hypoglycemia induced by 2-deoxyglucose (2DG) was compared with the prolonged fasting test as a possible screening test for detection of childhood hypoglycemia. Ten children, ages 2-9 yr, without a documented history of hypoglycemia were classified retrospectively as reference subjects. While fasting, their plasma glucose decreased to an average of 50 mg/dl (range, 30-74) between 28-36 h. After infusion of 2DG, 50 mg/kg IV over 30 min, their plasma glucose increased by an average of 35 mg/dl (range, 19-56) between 60-120 min. The half-life of plasma 2DG was 48 min.Twenty-three other children in the same age range had an abnormal response to one or both of these tests. Thirteen of these children became definitely hypoglycemic while fasting (glucose < 30 mg/dl) and also failed to increase their plasma glucose by more than 10 mg/dl after 2DG. Five children had plasma glucose values between 30-40 mg/dl during the first 24 h of fasting that were associated with a change in mental status but responded to 2DG with an increase in plasma glucose. The remaining five subjects had an apparently normal response to fasting but did not respond to 2DG; two of these had documented spontaneous hypoglycemia. No cases of documented hypoglycemia were undetected by either test. It is concluded that the 2DG test is a short safe supplement to fasting which is equally effective as the prolonged fasting test in detecting hypoglycemia. Neither test alone is completely reliable, but the combination is complementary. AbbreviationThe most direct approach to confirming a suspected diagnosis of spontaneous hypoglycemia is to measure blood glucose at the time of symptoms and, if possible, to demonstrate that symptoms are rapidly relieved after the blood glucose has been increased. This obvious approach is very often not successful in children because hypoglycemia is typically sporadic, brief, and may not be associated with definitive symptoms. When blood glucose values are obtained they may be equivocal. For these reasons, follow-up testing is frequently required to establish or confirm the diagnosis of hypoglycemia.Hypoglycemia in children due to various etiologies commonly occurs while fasting, and therefore fasting has been the most widely recommended general screening test (4, 10). If properly conducted, observations made during the fasting test can lead to a specific differential diagnosis in the event that the child does become hypoglycemic; however, as a test procedure, fasting has several practical disadvantages. Because the test may need to be continued for as long as 36 h or until the child becomes definitely ----~nter~retation may be compiicated by choice of appropriate reference standards and a variable relationship between blood glucose and symptoms (16). An especially frustrating outcome is to find that some children with documented spontaneous fasting hypoglycemia may fail to be distinguished from normal children under conditions ...

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Vagal Stimulation of Gastric Secretion in Man by 2-Deoxy-D-Glucose

Cited by 72 publications

References 10 publications

Endogenous orexin-A in the brain mediates 2-deoxy-d-glucose-induced stimulation of gastric motility in freely moving conscious rats

Endogenous orexin-A in the brain mediates 2-deoxy-d-glucose-induced stimulation of gastric motility in freely moving conscious rats

The 2-Deoxyglucose Test as a Supplement to Fasting for Detection of Childhood Hypoglycemia

The 2-Deoxyglucose Test as a Supplement to Fasting for Detection of Childhood Hypoglycemia

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