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Interstitial glucose in skeletal muscle of diabetic patients during an oral glucose tolerance test
Author(s) -
Frossard M.,
Blank D.,
Joukhadar Ch.,
Bayegan K.,
Schmid R.,
Luger A.,
Müller M.
Publication year - 2005
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2004.01360.x
Subject(s) - medicine , glucose tolerance test , diabetes mellitus , skeletal muscle , endocrinology , test (biology) , insulin resistance , paleontology , biology
Aim The presence of a transcapillary arterial–interstitial gradient for glucose (AIG glu ) in skeletal muscle may be interpreted as a consequence of intact cellular glucose uptake. We hypothesized that the AIG glu decreases in Type 2 diabetes mellitus as a consequence of insulin resistance, whereas it remains intact in Type 1 diabetes. Methods Glucose concentrations were measured in serum and interstitial space fluid of skeletal muscle during an oral glucose tolerance test (OGTT) in patients with Type 1 and Type 2 diabetes and in young and middle‐aged healthy volunteers, using microdialysis. Results The area under the curve for glucose in serum (AUC SE ) was higher than in interstitial space fluid of skeletal muscle (AUC MU ) in healthy young (AUC SE = 1147 ± 332 vs. AUC MU = 633 ± 257 mM/min/ml; P = 0.006), healthy middle‐aged volunteers (AUC SE = 1406 ± 186 vs. AUC MU = 1048 ± 229 mM/min/ml; P = 0.001) and in Type 1 diabetic patients (AUC SE = 2273 ± 486 vs. AUC MU = 1655 ± 178 mM/min/ml; P = 0.003). In contrast, in Type 2 diabetic patients AUC SE (2908 ± 1023 mM/min/ml) was not significantly different from AUC MU (2610 ± 722 mM/min/ml; P = NS). Conclusion The present data indicate that AIG glu is compromised in Type 2 diabetes in contrast to Type 1 diabetes where it appears to be normal. Because no changes in muscle blood flow were detected, insulin resistance appears to be the main cause for the observed decreased AIG glu in skeletal muscle in Type 2 diabetic patients.