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Evidence for altered control of glucose disposal after total colectomy

Published online by Cambridge University Press:  09 March 2007

M. Denise Robertson*
Human Nutrition Research Centre, Department of Biological and Nutritional Sciences, University of Newcastle, Newcastle-upon-Tyne NE1 7RU, UK
Geoff Livesey
Institute of Food Research, Colney Lane, Norwich NR4 7UA, UK
Shelagh M. Hampton
School of Biological Science, University of Surrey, Guildford GU2 5XH, UK
John C. Mathers
Human Nutrition Research Centre, Department of Biological and Nutritional Sciences, University of Newcastle, Newcastle-upon-Tyne NE1 7RU, UK
*Corresponding author: Dr M. Denise Robertson, present address Oxford Lipid Metabolism Group, Nuffield Dept Clinical Medicine, Radcliffe Infirmary, Oxford OX2 6HE, UK, fax +44 1865 224652, email
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Colonic fermentation of organic matter to short-chain fatty acids has been implicated in the improvement in insulin sensitivity achieved by feeding diets rich in complex carbohydrates. The present study assessed the potential role of the colon in determining postprandial glucose kinetics. Metabolic responses to a complex-carbohydrate test meal were determined in conjunction with a primed continuous infusion of D-[6,6-2H]glucose in a group of ileostomists and sex-matched controls. Glucose disposal (GD) was computed using non-steady-state kinetics on a single compartment model. Insulin sensitivity was derived using cumulative GD as the dependent variable, and time and the integrated insulin concentration as independent variables. The ileostomist group had a significantly higher postprandial plasma insulin concentration (P=0·034) compared with the control group, but no difference in the plasma glucose concentration. Total GD was similar in each group, although the insulin-dependent GD was substantially lower in the ileostomists (0·46 v. 0·13 mg glucose/min per pmol, P=0·015). The ileostomist group also showed a 50 % lower rate of glucose oxidation in the postprandial period (P=0·005), although the rate of non-oxidative GD was not significantly affected. The present study indicates that loss of the colon is associated with several characteristics of the insulin resistance syndrome, and favours a view that the colon has a role in the control of postprandial glucose.

Research Article
Copyright © The Nutrition Society 2000


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