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Titolo:
Differential effects of fasting and dehydration in the pathogenesis of diabetic ketoacidosis
Autore:
Burge, MR; Garcia, N; Qualls, CR; Schade, DS;
Indirizzi:
Univ New Mexico, Sch Med, Dept Med, Div Endocrinol, Albuquerque, NM 87131 USA Univ New Mexico Albuquerque NM USA 87131 rinol, Albuquerque, NM 87131 USA
Titolo Testata:
METABOLISM-CLINICAL AND EXPERIMENTAL
fascicolo: 2, volume: 50, anno: 2001,
pagine: 171 - 177
SICI:
0026-0495(200102)50:2<171:DEOFAD>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
GLUCOSE; INSULIN; REHYDRATION; PREVENTION; DIURETICS; POTASSIUM; THERAPY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Burge, MR Univ New Mexico, Sch Med, Dept Med Endocrinol 5ACC, Albuquerque,NM 87131 USA Univ New Mexico Albuquerque NM USA 87131 uquerque, NM 87131 USA
Citazione:
M.R. Burge et al., "Differential effects of fasting and dehydration in the pathogenesis of diabetic ketoacidosis", METABOLISM, 50(2), 2001, pp. 171-177

Abstract

Glycemia varies widely in patients with diabetic ketoacidosis (DKA), with plasma glucose concentrations between 10 to 50 mmol/L commonly encountered. The mechanism of this glycemic variability is uncertain. Our study examined the differential effects of fasting and dehydration on hyperglycemia induced by withdrawal of insulin in type 1 diabetes. To evaluate the respectiveroles of dehydration and fasting in the pathogenesis of DKA, 25 subjects with type 1 diabetes were studied during 5 hours of insulin withdrawal before (control) and after either 32 hours of fasting (n = 10) or dehydration of4.1% +/- 2.0% of baseline body weight (n = 15). Samples were obtained every 30 minutes during insulin withdrawal for substrate and counterregulatory hormone levels and rates of glucose production and disposal. Fasting resulted in reduced plasma glucose concentrations compared with the control study, while dehydration resulted in increased plasma glucose concentrations compared with the control study (P < .001). Glucose production and disposal were decreased during the fasting study and increased during the dehydration study compared with the control study. Glucagon concentrations and rates ofdevelopment of ketosis and metabolic acidosis were increased during both fasting and dehydration compared with control. These data suggest that fasting and dehydration have differential effects on glycemia during insulin deficiency, with dehydration favoring the development of hyperglycemia and fasting resulting in reduced glucose concentrations. This finding is probably attributable to the differing effect of these conditions on endogenous glucose production, as well as to differences in substrate availability and counterregulatory hormone concentrations. The severity of pre-existing fastingand dehydration likely explains much of the variability in plasma glucose concentrations observed in DKA. Copyright (C) 2001 by W.B. Saunders Company.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 12:05:10