Effects of Oral Administration of Hepatic Gluconeogenic Precursors in Insulin-Induced Hypoglycaemia ; Efeito da Administração Oral de Precursores Gliconeogênicos Hepáticos na Recuperação da Hipoglicemia Induzida por Insulina (HII)

Although intensive insulin therapy determines a strict glycaemic control, an increased incidence of insulin-induced hypoglycemia (IIH) occurs. The availability of gluconeogenic precursors is crucial for hepatic glucose production and oral supply promotes differentiated recovery of blood glucose. Since the liver plays a central role in the regulation of blood glucose, current research investigates its involvement in the mechanisms of IIH recovery by the oral administration of gluconeogenic precursors in rats fasting for 6 hours. Results show that glycerol, pyruvic acid and L-glutamine tended towards a rise in blood glucose levels 8 min after gavage. However, after 30 min, only L-alanine and L-glutamine showed the lowest decrease in blood glucose. Pyruvic acid and glycerol showed the same transient glucose effect on the recovery of blood glucose, or rather, an initial rise and subsequent worsening of the condition. After one hour the positive effect of L-alanine disappeared and became inappropriate for a decrease in blood glucose during prolonged periods, while L-glutamine maintained a higher glycaemic rate. Perhaps due to the fact that the hepatocyte is reduced when L-glutamine is the gluconeogenic precursor, the effect of this aminoacid would in the long run be favored. ; A terapia intensiva de insulina determina um controle glicêmico rigoroso, mas resulta numa incidência aumentada de hipoglicemia induzida pela insulina (HII). A disponibilidade de precursores gliconeogênicos é crucial para a produção hepática de glucose e sua oferta oral promove recuperação diferenciada da glicemia. Considerando que o fígado desempenha papel central na regulação da glicemia, nossa pesquisa teve como objetivo investigar sua participação nos mecanismos de recuperação da HII, a partir da administração oral de precursores gliconeogênicos em ratos com 6 horas de privação alimentar. Nossos resultados demonstraram que o glicerol, o piruvato e a L-glutamina apresentaram tendência de elevar a glicemia aos 8 min após gavagem. No entanto, ...