Kidney Effects Postprandial Glucose In Type 2 Diabetes

Recent studies have indicated an important role of the kidney in postprandial glucose homeostasis in normal humans. Researchers at the University of Rochester School of Medicine have now shown the kidney’s role in the abnormal postprandial glucose metabolism in type 2 diabetes.

Euglycemic and Diabetic volunteers were given 75gm of glucose and then observed.
Over the 4-1/2 hour postprandial period, diabetic subjects had increased mean blood glucose levels (14.1 vs 6.2) and increased systemic glucose appearance (100.0 vs 70.0). The latter was mainly due to the ~23 gm greater endogenous glucose release (39.8 vs 17.0).

Approximately 40% of the diabetic subjects’ increased endogenous glucose release was due to increased renal glucose release (19.6 vs 10.6). Postprandial systemic tissue glucose uptake was also increased in the diabetic subjects (82.3 vs 69.8) and its distribution was altered; renal glucose uptake was increased (21.0 vs 9.8) whereas muscle glucose uptake was normal.

It appears that both the liver and kidney contribute to postprandial overproduction of glucose. In addition postprandial renal glucose uptake is increased resulting in a shift in the relative importance of muscle and kidney for glucose disposal. This may provide an explanation for the renal glycogen accumulation characteristic of diabetes mellitus as well as a mechanism by which hyperglycemia may lead to diabetic nephropathy. Am J Physiol Endocrinol Metab (August 10, 2004)

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