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Impaired Glucose Disposal Contributes to Pre-Diabetes

Diverse mechanisms of postprandial hyperglycemia at work in pre-diabetes

WEDNESDAY, Dec. 20 (HealthDay News) -- Postprandial hyperglycemia in early diabetes can be due to an inability to clear glucose rather than due to either increased glucose appearance after a meal or due to an inability to suppress hepatic glucose production, according to the results of a study reported in the December issue of Diabetes.

Robert Rizza, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues measured glucose appearance, disappearance and endogenous glucose production in 32 subjects with impaired fasting glucose. Patients were tested after consuming a meal and, on a separate occasion, as part of a glucose tolerance test.

The researchers found that subjects with impaired fasting glucose had high glucose levels while fasting, as expected, and following glucose ingestion, but showed normal endogenous glucose production. Response to insulin was essentially normal in subjects with isolated impaired fasting glucose. Glucose disappearance, however, was impaired in subjects with impaired fasting glucose and with either impaired glucose tolerance or diabetes.

"It appears that there is substantial heterogeneity in the regulation of postprandial glucose metabolism in individuals with impaired fasting glucose and/or impaired glucose tolerance," the authors write. "This implies there are differences in the pathogenesis of pre-diabetes and therefore differences in the risk of subsequently developing diabetes and/or differences in response to therapeutic agents that seek to prevent diabetes.

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