Impaired insulin response after oral but not intravenous glucose in heart- and liver-transplant recipients.
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2003
- doi: 10.1097/01.TP.0000079833.86120.85
- issn: 0041-1337
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E. Henchoz et al., « Impaired insulin response after oral but not intravenous glucose in heart- and liver-transplant recipients. », Serveur académique Lausannois, ID : 10.1097/01.TP.0000079833.86120.85
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BACKGROUND: The prevalence of diabetes is high after transplantation. We hypothesized that liver transplantation induces additional alterations of glucose homeostasis because of liver denervation. METHODS: Nondiabetic patients with a heart (n=9) or liver (n=9) transplant and healthy subjects (n=8) were assessed using a two-step hyperglycemic clamp (7.5 and 10 mmol/L). Thereafter, an oral glucose load (0.65 g/kg fat free mass) was administered while glucose was clamped at 10 mmol/L. Glucose appearance from the gut was calculated as the difference between glucose appearance (6,6 2H2 glucose) and exogenous glucose infusion. Plasma insulin, glucagon-like peptide (GLP)-1 and gastric inhibitory polypeptide(GIP) concentrations were compared after intravenous and oral glucose. RESULTS: After oral glucose, the glucose appearance from the gut was increased 52% and 81% in liver- and heart-transplant recipients (P