Relationship between glucose oxidation and glucose tolerance in man

The study was performed to determine the influence of peripheral glucose utilization on glucose tolerance. Glucose oxidation was measured in a group of 6 normal subjects by means of continuous indirect calorimetry during a 100 g oral glucose tolerance test for 3 hr, comparing the control state with experimental inhibition or stimulation of glucose oxidation. Suprabasal oxidation, corresponding to oxidation in response to the load, mainly by insulin-dependent tissue, was obtained by subtracting basal oxidation (essentially by non-insulin dependent tissues) from total oxidation. Suprabasal oxidation of glucose was inhibited by a neutral fat infusion, and stimulated by means of dichloracetate. In the control test, from the 100 g glucose administered, 18 g participated to suprabasal oxidation during the 3 hr of the test. A neutral fat infusion, started 2 hr before the glucose load and lasting throughout the test, decreased suprabasal oxidation to 7.5 g, i.e. to 42% of the control value. With the fat infusion, a larger fraction of the energy consumption was shown to originate from lipid oxidation (37% versus 25% in controls, p < 0.05) at the expense of carbohydrate (CHO) oxidation (44% versus 60% in controls, p < 0.05). However, these major changes in peripheral glucose oxidation were accompanied by only a moderate decrease in glucose tolerance. Dichloracetate administered prior to the test increased suprabasal oxidation to 25 g glucose oxidized in the 3 hours following the glucose load, i.e. an increment of 39% above the control value. A larger fraction of energy consumption was derived from carbohydrates (77% versus 60% in controls, p < 0.05). However, no significant change was observed in glucose tolerance. These results indicate that marked changes of peripheral glucose oxidation have little influence on glucose tolerance and suggest that another mechanism, i.e. glucose storage, plays a larger role in regulating plasma glucose levels during oral glucose tolerance tests.