Circulation, Vol 88, 395-404, Copyright © 1993 by American Heart Association
J vom Dahl, WH Herman, RJ Hicks, FJ Ortiz-Alonso, KS Lee, KC Allman, ER Wolfe Jr, V Kalff and M Schwaiger
BACKGROUND. Animal studies have demonstrated reduced myocardial glucose
utilization in the diabetic heart, suggesting abnormalities in glucose
transport. This study was designed to evaluate myocardial glucose uptake as
assessed by 2-fluoro-(fluorine-18)2-deoxy-D-glucose (FDG) and positron
emission tomography (PET) in patients with insulin-dependent diabetes
mellitus (IDDM) under standardized metabolic conditions. METHODS AND
RESULTS. A hyperinsulinemic-euglycemic clamp technique was used during PET
data acquisition in nine healthy male volunteers and seven young male
patients with a history of IDDM for less than 5 years. Oxidative metabolism
was assessed with C-11 acetate, and glucose uptake was quantitatively
measured with FDG using Patlak graphic analysis. Hemodynamic data and C-11
acetate kinetics were comparable. Myocardial glucose uptake averaged 0.44
+/- 0.12 mumol.g-1.min-1 in normal subjects and 0.43 +/- 0.16
mumol.g-1.min-1 in patients with IDDM (P = NS). Blood tracer clearance was
also similar in both groups as determined by the ratio of peak blood tracer
activity to the activity at 55 to 60 minutes after tracer injection. F-18
activity ratio between myocardium and blood pool averaged 7.2 +/- 3.4 in
the normal heart and 7.5 +/- 3.0 in the diabetic heart (P = NS).
CONCLUSIONS. These data indicate that metabolic standardization and
supplementation with insulin in young patients with IDDM is associated with
myocardial glucose uptake similar to that observed in the normal heart.
Chronic therapy with insulin may prevent the metabolic abnormalities
observed in diabetic animal models.
ARTICLES
Myocardial glucose uptake in patients with insulin-dependent diabetes mellitus assessed quantitatively by dynamic positron emission tomography
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor.
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