Small glycemic increments (≤0.5 mmol/L) can exert suppressive actions on endogenous glucose production (EGP) however it is unclear if this is an insulin dependent or independent process. Here, we performed a low-rate glucose infusion in control participants without diabetes and in people with type 1 diabetes (T1D) to better understand this phenomenon. Glucose kinetics, hormones and metabolites were measured during a 1 mg/kg/min glucose infusion (90 min) which rapidly increased glucose by ∼0.3 mmol/L in control participants. Insulin concentrations and secretion quickly increased by ∼20%, resulting in a ∼40% suppression of EGP, while glucose disposal remained unchanged. Free fatty acids (FFA) and glucagon were gradually suppressed to ∼30% below baseline at 60 min. When repeated under constant basal insulin concentrations in participants with T1D, glucose infusion caused only partial and transient EGP suppression, hence glucose increased in a near-linear manner, reaching levels ∼2 mmol/L above baseline at 90 min. FFAs and glucagon remained unchanged, while glucose disposal modestly increased. This demonstrates that small glycemic increments exert subtle stimulatory effects on insulin secretion that have potent metabolic actions on the liver and adipose tissue. It is conceivable that subtle increases in glucose could potentially serve as a signal for β-cell adaptation.

中文翻译：

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血糖小幅升高对人体胰岛素分泌和内源性葡萄糖产生的影响


小的血糖增量 （≤0.5 mmol/L） 可对内源性葡萄糖产生 （EGP） 产生抑制作用，但尚不清楚这是胰岛素依赖性还是独立过程。在这里，我们对没有糖尿病的对照参与者和 1 型糖尿病 （T1D） 患者进行了低速率葡萄糖输注，以更好地了解这种现象。在 1 mg/kg/min 葡萄糖输注（90 分钟）期间测量葡萄糖动力学、激素和代谢物，该输注使对照组参与者的葡萄糖迅速增加约 0.3 mmol/L。胰岛素浓度和分泌迅速增加约 20%，导致 EGP 抑制约 40%，而葡萄糖处理保持不变。游离脂肪酸 （FFA） 和胰高血糖素在 60 分钟时逐渐被抑制至比基线低约 30%。当在 T1D 参与者的恒定基础胰岛素浓度下重复时，葡萄糖输注仅导致部分和短暂的 EGP 抑制，因此葡萄糖以近线性方式增加，在 90 分钟时达到高于基线 ∼2 mmol/L 的水平。FFA 和胰高血糖素保持不变，而葡萄糖处理量适度增加。这表明小的血糖增量对胰岛素分泌产生微妙的刺激作用，对肝脏和脂肪组织具有强大的代谢作用。可以想象，葡萄糖的细微增加可能会成为β细胞适应的信号。