2-3 diphosphoglycerate and tissue oxygenation in the cirrhotic

Increased 2-3 Diphosphoglycerate levels in cirrhotic patients have been reported. Previous studies did not show significant changes in 2-3 DPG in anaemic cirrhotic patients when compared to non anaemic cirrhotic patients, but the role played by alkalosis and/or hypoxia has not been investigated. To study this question, haematic 2-3 DPG was measured in 8 male patients with liver cirrhosis (histologically diagnosed) together with PO2, PCO2, pH and Hct. 2-3 DPG was also measured in 6 healthy male volunteers. We found a significant increase in blood 2-3 DPG of cirrhotic patients compared to control subjects (5,55 +/- 0,4 vs 2,18 +/- 0,3 mmol/l erythrocytes respectively, p less than 0,001) in agreement with previous studies. PO2 levels and Hct value did not show important changes, whereas PCO2 and pH resulted to be very altered when compared to normal values, even though we could not correlate these values with blood 2-3 DPG. We conclude that the genesis of 2-3 DPG increase is multifactorial, however an alteration in acid-base equilibrium seems to play a more important role than hypoxia.     

Oxygen dissociation curves in trained and untrained subjects.

Oxygen dissociation curves (ODC) in whole blood and organic phosphate concentrations in red cells were determined in 10 highly trained male athletes (TR), 6 semitrained subjects (ST) who played sports regularly at low intensities and 8 untrained people (UT). In all groups standard ODCs (37 degrees C, pH 7.40, PCO2 approximately 43 Torr) at rest and after a short exhaustive exercise were nearly identical, but PO2 values measured immediately after blood sampling and corrected to standard conditions tended to fall to the right of the in vitro ODC. Elevated P50 in the physically active [28.65 +/- 1.4 Torr (3.81 +/- 0.18 kPa) in ST, 28.0 +/- 1.1 Torr (3.73 +/- 0.15 kPa) in TR, but 26.5 +/- 1.1 Torr (3.53 +/- 0.15 kPa) in UT] were partly caused by different [DPG] (11.9 +/- 1.3 mumol/GHb in UT, 13.3 +/- 1.5 mumol/GHb in TR, 13.8 +/- 2.2 mumol/gHb in ST). There were remarkable differences in the shape of the curves between the groups. The slope "n" in the Hill plot amounted to 2.65 +/- 0.12 in UT, 2.74 +/- in ST and 2.90 +/- 0.11 in the TR (2 p against UT less than 0.001), leading to an elevated oxygen pressure of about 2 Torr (0.27 kPa) at 20% saturation and an augmented oxygen extraction of 5--7 SO2 at a PO2 of about 15 Torr (2kPa), which might be favorable at high workloads. The reason for the phenomenon could be an increased amount of young red cells in the blood of TR, caused by exercise induced hemolysis.     

Periodontal disease status of pregnant women with diabetes mellitus

The aim of the present study was to evaluate the association between type I diabetes mellitus (DM) and periodontal disease in pregnant women. Fifty-two pregnant women aged 27.9 +/- 6.9 years with type I DM participated in the present study. Forty-two non-pregnant type I female diabetics (mean age: 27.9 +/- 6.1 years) and 121 healthy non-pregnant women (mean age: 29.1 +/- 5.7 years) without diabetes formed the control group. All subjects were given a clinical periodontal examination including probing pocket depth (PPD), probing attachment level (PAL), assessment of plaque and gingivitis scores (SBI). Blood parameters included levels of hemoglobin, glycosylated hemoglobin, total cholesterol, triglyceride and leukocytes. The pregnant diabetic subjects showed despite a good metabolic control significantly higher values for the SBI compared to the controls. Pregnant diabetic subjects displayed a significant correlation between the dose of insulin per day and PPD (p < or = 0.05) as well as the PAL (p < or = 0.05). In conclusion, the results of the study indicate that pregnant diabetics demonstrate a higher degree of periodontal inflammation and destruction compared to non-pregnant diabetics and healthy non-pregnant patients.     

Increased fructose-lysine of nail protein and blood glucose control in diabetic patients

Furosine, which was formed by acid hydrolysis of fructose-lysine, was determined and used as an indicator of glycosylated protein. The diabetic patients had significantly higher fructose-lysine levels in finger nails than healthy subjects [10.8 +/- 4.6% (mean +/- S.D.) vs 4.2 +/- 1.1%]. The best correlation was found between the fructose-lysine value and the fasting blood glucose level determined 3 to 5 months before sampling nails in diabetics. These results suggest that the furosine derived from fructose-lysine in finger nails may become an indicator of blood glucose control during the past 3 to 5 months in diabetics.     

Monosaccharides bound to hemoglobins in normal and diabetic individuals. Evidence for glucose, mannose and galactose as sugars released by methanolysis of the different hemoglobin components

Direct evidence is given for the presence of glucose, mannose and galactose as the products of hydrolysis of hemoglobins A1a1, A1a2, A1b, A1c and A0. The presence of galactose cannot be explained by the earlier hypothesis of Amadori rearrangement and suggests the existence of further complex rearrangements. Monosaccharide content of the different hemoglobin components varies from 0.2-2.0 mol/mol of alpha beta dimer with an increase of 1.5-2.0-times in diabetic components. This increase is not accompanied by net charge differences, suggesting that additionally bound sugars are not responsible for the pI modification of these hemoglobins. The pattern of glucose, mannose and galactose ratio in normal individuals divides these hemoglobins into two classes, hemoglobins A1b, A1c and A0 (ratio 0.60:0.25:0.15) on one hand and hemoglobins A1a1 and A1a2 (ratio 0.40:0.40: 0.20) on the other. These findings suggest that diverse mechanisms for sugar binding might exist between these two classes of glycosylated hemoglobins. This difference disappears in diabetic components suggesting that the non-NH2-terminal sites are glycosylated in all components by a common mechanism. Increase in glucose at the expense of mannose and galactose, as observed in diabetics, could be an indicator of recent glycosylation.     

Sustained normoglycemia and remission phase in newly diagnosed type I diabetic subjects. Comparison between continuous subcutaneous insulin infusion and conventional therapy during a one year follow-up

After onset of type I diabetes 7 diabetics were randomized to subcutaneous insulin pump treatment (CSII) (age 12 to 29 years, mean: 21 years) and 7 diabetics to conventional insulin treatment (CI) (age 14 to 28 years, mean: 21 years). HbA1, glycosylated serum proteins and mean blood glucose (MBG) as parameters of metabolic control were determined monthly. After 2 months both groups showed HbA1 values in the normal range. Mean MBG values were (mean +/- SD) 116 +/- 7 mg/dl for CSII and 118 +/- 14 mg/dl for CI. Residual insulin secretion was determined monthly by fasting C-peptide. After 14 days, 5, 7, 8 months fasting C-peptide values were significantly (P less than 0.05) higher in CI. After one year fasting C-peptide was comparable in both groups (CSII and CI mean: 0.06 nmol/l). The administered insulin dose was comparable in both groups with a 55% reduction of insulin dose after 5 months in CSII (0.35 +/- 0.15 U/kg/24 h) and in CI after 7 months (0.31 +/- 0.28 U/kg/24 h). After 12 months of insulin therapy about 60% of the initial insulin dose was injected in both groups. 1 patient on CSII (12 years) and 2 patients on CI (15, 28 years) showed a complete remission (for 3-9 months) with no exogenous insulin and normal HbA1 values. 50% of the patients had episodes where they did need less than 0.2 U/kg/24 h insulin to maintain optimal diabetic control (3 CSII, 4 CI). During the first year of insulin treatment in type I diabetes with CSII as well as with CI a comparable near normalisation of diabetic control could be achieved.     

Polymorphonuclear cell derangements in type I diabetes

Polymorphonuclear cell function had been studied in 58 Type I diabetic subjects. Chemotaxis, phagocytosis, adherence, bactericidal activity, NBT reduction capacity were evaluated. We enumerated gamma Fc receptor bearing polymorphonuclear cells and the percentage of immune complexes containing polymorphonuclear cells. These data were studied in accordance with glycemic levels and the presence of infections. All polymorphonuclear functions were decreased compared to non-diabetic subjects with the exception of phagocytosis. The efficiency of the diabetic sera on normal subjects polymorphonuclear cells was decreased (bactericidal activity, chemotactic index and phagocytosis). These abnormalities were independent of the presence of infection. No correlation was found with glycemic level. The percentage of cells bearing an Fc gamma receptor was less in diabetics than in normal (70.1 +/- 17.4 vs 80.2 +/- 7.8%). The percentage of immune complexes containing polymorphonuclear cells was increased (n = 16, 9.06 +/- 4.7 vs 4.75 +/- 2.1% in normals). There again, these data are without correlation with the presence of infections or glycemic level.     

Oxygen transport properties of blood in two different bovine breeds

1. The whole oxygen dissociation curve of oxyhemoglobin has been determined in double-muscled cattle of the Belgian White Blue breed and in Friesian cattle of different body weight. 2. In calves, P50 values are low and DPG level is high (4-20 mumol/g Hb). 3. P50 values of 25 +/- 1.4 mm Hg (mean +/- SD) and a level of DPG less than 1.5 mumol/g Hb have been found in animals weighing more than 80 kg. 4. Effects of temperature and pH on the oxygen dissociation curve have been measured at all levels of saturation. The temperature coefficient (dlog P50/dT) and the Bohr effect expressed as dlog P50/dpH were 0.017 and -0.40, respectively. 5. Hematocrit, hemoglobin concentrations and oxygen capacity of hemoglobin have been measured. 6. No difference between both breeds has been observed. 7. These data can be used to correct measured values of oxygen tension for temperature and pH and to measure oxygen content of blood in cattle.     

Influence of metabolic equilibrium on erythrocyte deformability in diabetes mellitus

Red blood cell filtration test (Reid's test) was performed in 23 diabetic patients and in 10 normal subjects and it was related to metabolic equilibrium. Results showed an increase of filtration time in diabetics when compared to controls (35.1' +/- 2.3; M +/- SEM vs 22.2' +/- 0.7, p less than 0.001) and a significant correlation to cholesterol (178.7 mg% +/- 8.9, r = 0.40, p less than 0.05), triglycerides (131.3 mg% +/- 20.6, r = 0.72, p less than 0.001) and to glycosylated hemoglobin (10.7% +/- 0.5, r = 0.60, p less than 0.01) in diabetic patients. No correlation was observed in control subjects. The values of red blood cells filtration time observed in diabetics suggest that an altered erythrocyte deformability in diabetic patients can play an important role in peripheral hypoxia and therefore in diabetic microangiopathy.     

Three months energy restricted diet does not reduce peripheral insulin resistance in newly diagnosed non insulin dependent diabetics

Sixteen newly diagnosed non insulin dependent diabetic patients were treated for 3 months with an individual energy restricted diet. The effect on weight, hyperglycaemia and insulin response to oral glucose was measured in all subjects, and in 7, peripheral insulin resistance was estimated using a hyperinsulinaemic glucose clamp at two insulin infusion rates (40 and 400 mU m-2 X min-1). After diet, fasting plasma glucose fell from 12.0 +/- 0.7 mmol/l (mean +/- SEM) to 7.4 +/- 0.5 mmol/l (P less than 0.001) and weight fell from 92.9 +/- 4.2 kg to 85.0 +/- 3.1 kg (P less than 0.001). The plasma insulin response to oral glucose was unchanged after diet therapy. Insulin induced glucose disposal (M) was also unaffected by diet at insulin infusion rates of 40 mU m-2 X min-1 (12.5 +/- 1.5 mumol X kg-1 X min-1 vs 15.7 +/- 1.6 mumol X kg-1 X min-1) and 400 mU m-2 X min-1 (49.5 +/- 2.7 mumol X kg-1 X min-1 vs 55.1 +/- 2.5 mumol X kg-1 X min-1). These results show that 3 months reduction of energy consumption with weight loss in newly diagnosed non insulin dependent diabetics improves B-cell responsiveness to glucose but has no effect on liver glucose output or on peripheral insulin action.     

Changes in mean erythrocyte volume and 2,3-diphosphoglycerate in two groups of diabetic subjects

Mean corpuscular volume and Red Blood Cell 2-3, diphosphoglycerate in insulin dependent diabetics and in non insulin dependent diabetics were evaluated. Only in insulin dependent diabetics an increased mean corpuscular volume was found while in non insulin dependent diabetics red blood cell 2-3, DPG level appears to be reduced. These findings were not correlated with the metabolic parameters neither they seemed to be dependent upon sex, age or vascular disease. The Authors suggest that the increase of mean corpuscular volume might be indicative of a tendency to macromegaloblastosis in insulin dependent diabetics; with regard to RBC 2-3, DPG level it seems to be extremely variable in dependence on oxygen request at the tissue level.     

Glycosylated hemoglobins in a diabetic patient with sickle cell anemia

Results of analysis of blood samples from a diabetic sickle cell anemia (SS) patient and 4 nondiabetic SS patients for glycosylated hemoglobins by Bio-Rex 70 chromatography, high-pressure liquid chromatography, and affinity chromatography are presented. Glycosylated components of Hb S and Hb A2 and total glycosylated hemoglobins were quantitated in this manner. The levels of the various glycosylated hemoglobins were increased twofold in the diabetic patient compared to nondiabetic SS patients. The glycosylated hemoglobin levels in the diabetic SS patient and in the nondiabetic SS patients, however, were significantly lower than the levels normally seen in nonsickle diabetics and normal adults, respectively. In contrast to a previously reported diabetic SS patient, the present case appears to be not severely affected by sickle cell disease.     

Molecular basis for ATP/2,3-bisphosphoglycerate control switch-over (poikilotherm/homeotherm) an intermediate amino-acid sequence in the hemoglobin of the great Indian rhinoceros (Rhinoceros unicornis, Perissodactyla)

The complete primary structure of the two hemoglobin components of the Great Indian Rhinoceros (Rhinoceros unicornis) is presented. The ratio for the two components B(alpha 2 beta I2): A(alpha 2 beta II2) is 6:4. Polypeptide subunits were separated by chromatography on CM-cellulose in a buffer containing 8M urea. The sequence was studied by degradation of the tryptic and hydrolytic cleavage products in a liquid phase sequencer. At position beta NA2 component B has Asp, whereas component A has Glu, an ATP-binding site in fish and reptilian hemoglobins. The other phosphate binding sites i.e. beta NA1 Val, beta EF6 Lys and beta H21 His are identical with 2,3-bisphosphoglycerate-(DPG)binding sites in mammalian hemoglobins, whereby rhinoceros hemoglobin resembles both ATP-sensitive poikilotherm hemoglobin and DPG-sensitive mammalian hemoglobin. The two components (beta I/beta II) additionally differ by exchange of Glu----Gly at position beta A3 and Gln----Lys at position beta GH3. The significance of these changes is discussed. Oxygenation properties of the two hemoglobins components and their dependence on ATP and DPG are given. The structure and function of Rhinoceros hemoglobin may give an insight into the evolution of the organic phosphate binding in vertebrate hemoglobins.     

Human plasma C-peptide immunoreactivity: its correlation with immunoreactive insulin in diabetes, and chronic liver and renal diseases.

The correlation between plasma C-peptide immunoreactivity (CPR) and immunoreactive insulin (IRI) was investigated during the oral glucose tolerance test in 20 normals, 127 diabetics, and 39 non-diabetics with chronic liver or renal disorders. When all subjects were included, the increment of CPR 30 minutes after glucose load (deltaCPR) correlated well with that of IRI (deltaIRI) (r = 0.66, p less than 0.001), but the return of CPR towards the basal level was delayed as compared with IRI. The positive correlation was also observed between the sum of 6 IRI and that of 6 CPR values during the glucose tolerance test in diabetics and controls (r = 0.53, p less than 0.001). deltaCPR/deltaBS (30 min.) was also well correlated with deltaIRI/deltaBS (30 min.), and was specifically low in diabetics. Insulin-treated maturity-onset diabetics showed low but considerable CPR responses while no CPR responses were observed in insulin-treated juvenile diabetics. In each plasma sample, CPR always exceeded IRI on the molar basis. At fasting CPR/IRI ratio was 15.6 +/- 1.7 (mean +/- SE) in normals and 14.9 +/- 1.3 approximately 16.9 +/- 1.0 in diabetics. In chronic liver diseases IRI response was augmented while CPR response was not different from that of controls, and the molar ratio of CPR/IRI was significantly low (9.5 +/- 1.1). On the contrary, it exceeded that of normals in chronic renal diseases (35.7 +/- 14.9). It is concluded that, first, the plasma CPR response appears to be a valuable indicator of pancreatic B-cell function, and second, it is, nevertheless, modified in chronic liver or renal disorders.     

Hemoglobin affinity for 2,3-bisphosphoglycerate in solutions and intact erythrocytes: studies using pulsed-field gradient nuclear magnetic resonance and Monte Carlo simulations.

The diffusion coefficient (D) of 2,3-bisphosphoglycerate (DPG) was measured using pulsed-field gradient (PFG)-31P nuclear magnetic resonance spectroscopy in solutions containing 2.7-5.0 mM hemoglobin (Hb) and a range of DPG concentrations. The dependence of the measured values of D on the fraction of the total DPG in the sample that is bound to Hb enabled the estimation of the dissociation constants (Kd) of complexes of DPG with carbonmonoxygenated, oxygenated, and deoxygenated Hb; the values of Kd (mM), measured at 25 degrees C, pH 6.9 and in 100 mM bis Tris/50 mM KCl, were 1.98 +/- 0.26, 1.8 +/- 0.5 and 0.39 +/- 0.26, respectively. In intact erythrocytes the apparent diffusion coefficient, Dapp, of DPG was larger in oxygenated and carbonmonoxygenated cells (6.17 +/- 0.20 x 10(-11) m2s-1) than in deoxygenated cells (4.10 +/- 0.23 x 10(-11) m2s-1). Changes in intracellular DPG concentration (5-55 mM) in erythrocytes, brought about by incubation in a medium containing inosine and pyruvate, did not result in significant changes in the value of Dapp; this result supports the hypothesis that DPG binds to other sites in the erythrocyte. Monte Carlo simulations of diffusion in biconcave discs were used to test the adequacy of the values of Kd estimated in solution to describe the binding of DPG to Hb in oxygenated and deoxygenated erythrocytes. The results of the simulations implied that the value of Kd estimated for deoxygenated Hb-DPG was greater than expected from the experiments involving intact erythrocytes. This difference is surmised to be at least partly due to the difficulty of measuring D at low-ligand concentrations. Notwithstanding this shortcoming, the PFG method appears to be suitable for probing interactions between macromolecules and ligands when the Kd is in the millimolar range. It is one of the few techniques available in which these interactions can be studied in intact cells. In addition, the Monte Carlo simulations of the diffusion experiments highlighted important differences between theory and experiment relating to the nature of molecular motion inside the cells.     

Hyperammoniemia during prolonged exercise: an effect of glycogen depletion?

Eight healthy men exercised to exhaustion on a cycle ergometer at a work load of 176 +/- 9 (SE) W corresponding to 67% (range 63-69%) of their maximal O2 uptake (exercise I). Exercise of the same work load was repeated after 75 min of recovery (exercise II). Exercise duration (range) was 65 (50-90) and 21 (14-30) min for exercise I and II, respectively. Femoral venous blood samples were obtained before and during exercise and analyzed for NH3 and lactate. Plasma NH3 was 12 +/- 2 and 19 +/- 6 mumol/l before exercise I and II, respectively and increased during exercise to exhaustion to peak values of 195 +/- 29 (exercise I) and 250 +/- 30 (exercise II) mumol/l, respectively. Plasma NH3 increased faster during exercise II compared with exercise I and at the end of exercise II was threefold higher than the value for the corresponding time of exercise I (P less than 0.001). Blood lactate increased during exercise I and after 20 min of exercise was 3.7 +/- 0.4 mmol/l and remained unchanged until exhaustion. During exercise II blood lactate increased less than during exercise I. It is concluded that long-term exercise to exhaustion results in large increases in plasma NH3 despite relatively low levels of blood lactate. It is suggested that the faster increase in plasma NH3 during exercise II (vs. exercise I) reflects an increased formation in the working muscle that may be caused by low glycogen levels and impairment of the ATP resynthesis.     

Decreased thyroid hormone-stimulated oxygen consumption and glucose uptake in mononuclear blood cells from patients with autosomal dominant osteopetrosis type I

Nine patients, from four different families, with autosomal dominant osteopetrosis were investigated. They all had roentgenological type I disease, characterized by universal, symmetrical osteosclerosis and enlarged thickness of the cranial vault. All patients appeared clinically euthyroid. Thyroxine (T4) and tri-iodothyronine (T3) induced oxygen consumption and glucose uptake were studied in vitro in mononuclear blood cells from patients and control persons. Unstimulated oxygen consumption from patients and controls did not differ, and no difference in unstimulated glucose uptake was observed. The increase in T4 and T3 stimulated oxygen consumption was significantly lower in cells from patients with osteopetrosis (T4: 0.007 +/- 0.004 mumol/mg DNA per h, T3: 0.011 +/- 0.004 mumol/mg DNA per h) compared with controls (T4: 0.017 +/- 0.003 mumol/mg DNA per h, T3: 0.023 +/- -0.013 mumol/mg DNA per h; p less than 0.05, p less than 0.05). Cellular glucose uptake after T4 and T3 stimulation was significantly lower in patients (T4: 0.032 +/- 0.017 mmol/l per mg DNA per h, T3: 0.02 +/- 0.017 mmol/l per mg DNA per h) compared with controls (T4: 0.09 +/- 0.017 mmol/l per mg DNA per h, T3: 0.08 +/- 0.01 mmol/l per mg DNA per h; p less than 0.05, p less than 0.01). The reduced oxygen consumption and glucose uptake indicate thyroid hormone resistance which may be of pathogenetic importance for the development of autosomal dominant osteopetrosis type I.     

Gastric inhibitory polypeptide (GIP) concentration in human amniotic fluid

Several studies report that placenta and amniotic fluid (AF) may be a source of many peptide hormones. Although the presence of gastric inhibitory polypeptide (GIP) in amniotic fluid has not been described, it is present in the fetal gut. In this study we report the presence of insulin and GIP in human AF of normal and diabetic pregnancies. GIP concentrations in the AF collected two hours after an arginine tolerance test (ATT), at 34-36 weeks of gestation, were evaluated in 8 normal and 53 diabetic pregnant women. GIP was found in all samples of AF. The mean AF-GIP concentrations were 133 +/- 19 pmol/l in controls and 111 +/- 6 pmol/l in the diabetics, being the GIP values of the diabetics belonging to White Class B significantly lower than those of normals (99 +/- 10 vs 133 +/- 19 pmol/l). The GIP/IRI molar ratio was significantly lower in the diabetics than in controls (1.2 +/- 0.2 vs 2.5 +/- 0.4); moreover the GIP/IRI molar ratio was significantly higher in AF collected from diabetic pregnant women who delivered overweight infants than in AF of normal weight infants or controls. This finding would suggest a negative feedback mechanism between GIP and insulin in fetus.     

Thiazolidinediones improve beta-cell function in type 2 diabetic patients

Thiazolidinediones (TZDs) improve glycemic control and insulin sensitivity in patients with type 2 diabetes mellitus (T2DM). There is growing evidence from in vivo and in vitro studies that TZDs improve pancreatic beta-cell function. The aim of this study was to determine whether TZD-induced improvement in glycemic control is associated with improved beta-cell function. We studied 11 normal glucose-tolerant and 53 T2DM subjects [age 53+/-2 yr; BMI 29.4+/-0.8 kg/m2; fasting plasma glucose (FPG) 10.3+/-0.4 mM; Hb A1c 8.2+/-0.3%]. Diabetic patients were randomized to receive placebo or TZD for 4 mo. Subjects received 1) 2-h OGTT with determination of plasma glucose, insulin, and C-peptide concentrations and 2) two-step euglycemic insulin (40 and 160 mU.m-2.min-1) clamp with [3-(3)H]glucose. T2DM patients were then randomized to receive 4 mo of treatment with pioglitazone (45 mg/day), rosiglitazone (8 mg/day), or placebo. Pioglitazone and rosiglitazone similarly improved FPG, mean plasma glucose during OGTT, Hb A1c, and insulin-mediated total body glucose disposal (Rd) and decreased mean plasma FFA during OGTT (all P<0.01, ANOVA). The insulin secretion/insulin resistance (disposition) index [DeltaISR(AUC)/Deltaglucose(AUC)/IR] was significantly improved in all TZD-treated groups: +1.8+/-0.7 (PIO+drug-na?ve diabetics), +0.7+/-0.3 (PIO+sulfonylurea-treated diabetics), and 0.7+/-0.2 (ROSI+sulfonylurea-withdrawn diabetics) vs. -0.2+/-0.3 in the two placebo groups (P<0.01, all TZDs vs. placebo, ANOVA). Improved insulin secretion correlated positively with increased body weight, fat mass, and Rd and inversely with decreased plasma glucose and FFA during the OGTT. In T2DM patients, TZD treatment leads to improved beta-cell function, which correlates strongly with improved glycemic control.     

The effect of thyroxine on the 2,3-diphosphoglycerate content of erythrocytes in vivo and in vitro]

After ending a continous treatment with thyroxine the average dropping of the 2,3 DPG level was 0.4 mumol/ml. T4 decreased on the average by 7.6 microgram/ml. One time application of 1 mg thyroxine p.o. led within 24 hours to an increase of the 2,3 DPG level of -chi = 0.2 mumol/ml, the pH in the erythrocytes increased by 0.02 on the average. Blood incubation with thyroxine added in a concentration of -chi = 24 microgram/100 ml showed no increase of 2,3 DPG, pH and phosphate, while there was a significant acidosis and increase of phosphate in the control blood. The lactate production was significantly lower and glucose consumption was significantly higher in the blood with thyroxine.