Glucose intolerance and insulin resistance in patients with liver disease

An attempt was made to distinguish the glucose intolerance observed in patients with liver disease from that seen in patients with genetically determined diabetes mellitus. Serum glucose and insulin levels were measured during oral and intravenous glucose tolerance tests (GTT) in patients with liver disease, in mild diabetics, and in control subjects. Eleven of the 16 patients with liver disease had abnormal oral GTT results. The patients with liver disease and the diabetics had comparable degrees of glucose intolerance during both the oral and intravenous GTT, despite the presence of hyperinsulinemia in the former group. The mean "total insulin excess" was approximately twice as great in the patients with liver disease as in the diabetics. The mean rate constant, Kg, for the decrease in serum glucose concentration after termination of infusion was 1.12% and 1.07% per minute, respectively. These observations suggest that significant insulin resistance was present in patients with