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Effect of Time on Measurement of Hepatic Glucose Production^*

Y.-D. IDA CHEN, ARTHUR L. M. SWISLOCKI, CHII-Y JENG, JYUHN-H JUANG and GERALD M. REAVEN

Department of Medicine, Stanford University School of Medicine, and the Geriatric Research, Education, and Clinical Center, Veterans Administration Medical Center Palo Alto, California 94304

Address all correspondence and requests for reprints to: Gerald M. Reaven, M.D., Veterans Administration Medical Center, GRECC/182B, 3801 Miranda Avenue, Palo Alto, California 94304.

Basal hepatic glucose production (HGP) was determined in obese and nonobese normal subjects and patients with noninsulin-dependent diabetes mellitus (NIDDM) using [3-³H] glucose and the nonsteady state equations of Steele. When HGP was estimated at hourly intervals from 0800-1300 h, it became evident that calculated values for HGP fell for the first 2–4 h until a plateau was reached, and this decline was quite precipitous during the first 2 h in patients with NIDDM. Furthermore, when the same patient with NIDDM was studied on two occasions, similar values for HGP were not uniformly obtained unless measurements were made at least 4 h after [3-³H] glucose administration. Since it has been the convention to use the nonsteady state equations of Steele to calculate HGP in patients with NIDDM 2 h after [3-³H] glucose administration, it is almost certain that published values for HGP in patients with NIDDM are falsely high. Based upon the data presented, we suggest that HGP using [3-³H]glucose and the nonsteady state Steele equations be measured for at least a 4-h period in patients with NIDDM in order to increase the validity of the calculated value.

^* This work was supported by Research Grants from the NIH (RR-7022 and DK-30732) and the Nora Eccles Treadwell Foundation.

Fellow of the Triservice Hospital, Taipei, Taiwan, Republic of China.

Fellow of Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.

Received February 1, 1988.

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