caa a22 4500 465745342 CHVBK 20180323111819.0 cr unu---uuuuu 170327e19900701xx s 000 0 eng 10.1007/BF02581332 doi (NATIONALLICENCE)springer-10.1007/BF02581332 Quantitative and qualitative differences in basal and glucose- and arginine-stimulated insulin secretion in healthy subjects and different stages of NIDDM [Elektronische Daten] [Klaus Ratheiser, Wolfgang Reitgruber, Martin Komjati, Paul Bratusch-Marrain, Heinrich Vierhapper, Werner Waldhäusl] Summary: To determine quantitative and qualitative differences in insulin secretion equimolar amounts of glucose and arginine were infused in 9 healthy subjects, in 8 individuals each with obesity without and with impaired glucose tolerance, and in non-obese and obese non-insulin-dependent diabetic patients (NIDDM). Insulin secretion was calculated after individual determination of metabolic clearance rate of C-peptide (MCRcp) both as the area under the C-peptide concentration curve times MCRcp, and by a mono-compartment mathematical model, both yielding identical results. MCRcp fell consistently with increasing C-peptide infusion rate (e.g.: healthy subjects: C-peptide, 10 nmol/h, 4.2±0.4; 20 nmol/h, 3.3±0.3; 30 nmol/h, 3.1±0.2 ml/kg · min; p<0.05 to p<0.01). Basal insulin secretion was 2.1-fold greater in the obese with impaired glucose tolerance than in healthy subjects, but was unchanged in non-obese NIDDM. Glucose and arginine triggered insulin release was greater than in healthy subjects at almost identical area under the respective substrate concentration curve (AUC/kg body weight) in obese subjects without (2-fold) and with impaired glucose tolerance (4-fold), and in NIDDMs following i.v. arginine (2-fold). The mean ratio of incremental insulin release to i.v. glucose and arginine was smaller in NIDDM (normal weight, 1.3±0.4; obese, 1.0±0.2) than in healthy (2.0±0.3), or obese subjects with impaired glucose tolerance (2.8±0.7). Stimulated C-peptide/insulin ratio was reduced in all patientsvs that in healthy subjects (p<0.05). We conclude that (a) MCR of C-peptide is in part a saturable process; (b) insulin clearance may be impaired in obesity and NIDDM; and (c) insulin secretion differs in obese states and NIDDM both quantitatively and qualitatively, and thereby separates the two disorders as different entities. In addition, quantitation of insulin release in obese states may also help (d) to better define primary algorithms for insulin replacement in normal- and overweight insulin-dependent diabetic patients. Casa Editrice il Ponte, 1990 Arginine nationallicence C-peptide/insulin ratio nationallicence Glucose nationallicence Impaired glucose tolerance nationallicence Insulin secretion nationallicence NIDDM nationallicence Obesity nationallicence Substrate recognition nationallicence Ratheiser Klaus Division of Clinical Endocrinology and Diabetology, 1. Medizinische Universitätsklinik, Wien aut Reitgruber Wolfgang Institute for Analysis and Technical Mathematics, Technische Universität, Wien, Austria aut Komjati Martin Division of Clinical Endocrinology and Diabetology, 1. Medizinische Universitätsklinik, Wien aut Bratusch-Marrain Paul Division of Clinical Endocrinology and Diabetology, 1. Medizinische Universitätsklinik, Wien aut Vierhapper Heinrich Division of Clinical Endocrinology and Diabetology, 1. Medizinische Universitätsklinik, Wien aut Waldhäusl Werner Division of Clinical Endocrinology and Diabetology, 1. Medizinische Universitätsklinik, Wien aut Acta diabetologia latina Springer-Verlag 27/3(1990-07-01), 197-213 0001-5563 27:3<197 1990 27 592 https://doi.org/10.1007/BF02581332 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF02581332 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ratheiser Klaus Division of Clinical Endocrinology and Diabetology, 1. Medizinische Universitätsklinik, Wien aut NATIONALLICENCE 700 1- Reitgruber Wolfgang Institute for Analysis and Technical Mathematics, Technische Universität, Wien, Austria aut NATIONALLICENCE 700 1- Komjati Martin Division of Clinical Endocrinology and Diabetology, 1. Medizinische Universitätsklinik, Wien aut NATIONALLICENCE 700 1- Bratusch-Marrain Paul Division of Clinical Endocrinology and Diabetology, 1. Medizinische Universitätsklinik, Wien aut NATIONALLICENCE 700 1- Vierhapper Heinrich Division of Clinical Endocrinology and Diabetology, 1. Medizinische Universitätsklinik, Wien aut NATIONALLICENCE 700 1- Waldhäusl Werner Division of Clinical Endocrinology and Diabetology, 1. Medizinische Universitätsklinik, Wien aut NATIONALLICENCE 773 0- Acta diabetologia latina Springer-Verlag 27/3(1990-07-01), 197-213 0001-5563 27:3<197 1990 27 592 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer