Lower arterial glucose concentrations in lambs with aortopulmonary shunts after an 18-hour fast

GCM Beaufort-Krol*, J Takens, GB Smid, MC Molenkamp, WG Zijlstra, JRG Kuipers

*Corresponding author for this work

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2 Citations (Scopus)


Spontaneously occurring hypoglycemia has been described in children with severe acute congestive heart failure. Hypoglycemia may he the result of an increase in glucose utilization in tissues, a decrease in glucose production, or a decrease in the dietary intake of nutrients. To determine whether hypoglycemia may also occur in congenital heart disease with volume overloading, we investigated glucose metabolism during and after an 18-hour fast in nine lambs with an aortopulmonary left-to-right shunt and nine control lambs. Plasma levels of hormones involved in the endocrine control of glucose metabolism were determined. The glucose production rate (rate of appearance [R-a]) was studied using [U-C-13]glucose. Gluconeogenesis through the Cori cycle was estimated by measuring glucose C-13 recycling. The arterial glucose concentration (3,409 +/- 104 v 4,338 +/- 172 mu mol/L, P <.001) and R-a of glucose (16.97 +/- 0.89 v 25.49 +/- 4.28 mu mol . min(-1). kg(-1), P <.05) were lower in shunt versus control lambs. There were no differences in hormone levels between control and shunt lambs. Fractional glucose C-13 recycling via the Cori cycle (6.9% +/- 2.8% v 7.1% +/- 2.5%) and gluconeogenesis from pyruvate and lactate (1.24 +/- 0.58 v 1.95 +/- 0.67 mu mol . min(-1). kg(-1)) were similar in both groups of lambs. The sum of glycogenolysis and gluconeogenesis from precursors other than pyruvate and lactate was lower in shunt versus control lambs (15.73 +/- 1.07 v 23.54 +/- 4.27 mu mol . min(-1). kg(-1), P <.05). In conclusion, after an 18-hour fast, the arterial glucose concentration is lower in lambs with aortopulmonary shunts. This lower glucose concentration is associated with a decreased glucose production rate. In shunt lambs, glycogenolysis is decreased, while there is no difference in gluconeogenesis or hormonal control. Copyright (C) 1999 by W.B. Saunders Company.

Original languageEnglish
Pages (from-to)1082-1088
Number of pages7
Issue number9
Publication statusPublished - Sept-1999


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