Glucose tolerance testing after intravenous betamethasone phosphate, with concomitant uric acid and cholesterol analyses. A reassessment of both glucocorticoid and ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1971-01

AUTHORS

H. J. Roberts

ABSTRACT

The intense, sustained and predictable glucocorticoid action of i.v. betamethasone disodium phosphate (BSP) has been used as an effective method of stressing the insulinogenic reserve before glucose tolerance testing (GTT). The 13 selected patients in this study received 4.5 mg of BSP 16 to 18 hrs before ingesting a 100 g glucose load. «Early chemical diabetes» was suspected in 8 patients on the basis of the following: 1) clinical features such as hypercholesterolemia, transient glucosuria, diabetic-like peripheral neuropathies, gout, and large babies; 2) a family history of diabetes, especially when bilateral; and 3) nondiabetic or equivocal responsesboth by conventional morning glucose tolerance testing (MGTT) and afternoon glucose tolerance testing (AGTT).Every patient showed an unequivocal diabetic response after BSP priming. Five patients evidencing decreased glucose tolerance by AGTT, but not by MGTT, also were studied. Their diabetic diathesis was readily confirmed by BSP-GTT, even after improvement of glucose tolerance had been evidenced by repeat AGTT following treatment with diet and oral hypoglycemic drugs. The diagnostic and prognostic usefulness of corticosteroid-GTT remains limited, since it imposes apharmacologic stress upon the insulinogenic reserve. This contrasts with thephysiologic method of AGTT, which has demonstrated decreased tolerance in most diabetic suspects whose responses to MGTT proved nondiabetic or equivocal. Prognostically, depletion of the insulinogenic reserve is probably more advanced in the patient with «early chemical diabetes» whose diagnostic hyperglycemia is demonstrable by AGTT than when it can be evoked only after glucocorticoid priming. The paradoxic postglucose rise in the uric acid concentration, cholesterol concentration, or both, during AGTT and BSP-GTT in certain patients has been demonstrated. The implications of these phenomena relative to the pathogenesis and treatment of gout, hypercholesterolemia, and «secondary sulfonylurea failure» are discussed. More... »

PAGES

437-468

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/bf01550881

DOI

http://dx.doi.org/10.1007/bf01550881

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1020676256

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/5116954


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