Pathogenesis of prediabetes: Role of the liver in isolated fasting hyperglycemia and combined fasting and postprandial hyperglycemia

Abstract

Context: People with prediabetes are at high risk of developing diabetes. Objective: The objective of this study was to determine the pathogenesis of fasting and postprandial hyperglycemia in prediabetes. Design: Glucose production, gluconeogenesis, glycogenolysis, and glucose disappearance were measured before and during a hyperinsulinemic clamp using [6,6- 2H2]glucose and the deuterated water method corrected for transaldolase exchange. Setting: The study was conducted at the Mayo Clinic Clinical Research Unit. Participants: Subjects with impaired fasting glucose (IFG)/normal glucose tolerance (NGT) (n = 14), IFG/impaired glucose tolerance (IGT) (n = 18), and normal fasting glucose (NFG)/NGT (n = 16) were studied. Intervention: A hyperinsulinemic clamp was used. Outcome Measures: Glucose production, glucose disappearance, gluconeogenesis, and glycogenolysis were measured. Results: Fasting glucose production was higher (P