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KMID : 0354719740020010005
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Journal of Korean Diabetes Association
1974 Volume.2 No. 1 p.5 ~ p.12
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Studies of Blood Glucose, Plasma Insulin, and Free Fatty Acid Levels During Oral Glucose Loading in Thyrotexicosis
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Abstract
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An abnormal oral glucose tolerance curve is a common accompaniment of thyrotoxicosis. The increased frequency of diabetes mellitus in hyperthyroidism and the adverse effect of hyperthyroidism on patients with diabetes mellitus is well established-
The mechanism contributing to this impaired carbohydrate tolerance is unclear. Glucose tolerance is dependent upon the interaction of tissue sensitivity to insulin and the magnitude of insulin secretion. During the hyperthyroid state, tissue sensitivity to insulin has been variably reported to be increased (Elrick et al., 1961), or decreased (Doar et al., 1969). The result of insulin secretion studies have also been quite varied; decreased (Renauld et al., 1971), normal (Hales and Hyams, 1964), or in creased (Doar et al., 1969).
The mechanism of glucose and free fatty acid (FFA) have been shown to be interrelated in such a way that either may reduce the oxidation of the other (Randle et al., 1963). Hales and Hyams (1964) advanced the hypothesis that the reduced glucose tolerance in thyrotoxic patients was secondary to an increased concentration of FFA in plasma.
The present study investigations were carried out with the object of determining whether there was any relationship among the impairment of glucose tolerance, plasma insulin and plasma FFA concentrations.
The blood glucose, plasma insulin, and plasma FFA concentrations during 50 gm. oral glucose loading were measured in 8 normal and 12 thyrotoxic subjects to study the glucose metabolism in thyrotoxicosis.
Following were the results:
1. By Wilkerson´s criteria, eight of twelve thyrotoxic subjects (67 percent) had abnormally
high glucose level after oral glucose loading. In comparing with control group, the mean blood glucose level of thyrotoxic patients after oral glucose loading was significantly elevated in comparing with that of control subjects.
2. The mean plasma insulin concentrations were not significantly different between two groups, but the postprandial one hour value was significantly increased in thyrotoxic group.
3. The fasting mean plasma FFA level of thyrotoxic group was 1.8 times- higher than that of control group and after glucose loading plasma FFA concentration decreased more rapidly in thyrotoxic group.
In view of the above experimental findings, the mechanism of abnormal carbohydrate metabolism in the patients with thyrotoxicosis may be interpreted as deficiency of insulin effectivity than that of insulin secretion.
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