c-peptide and Tuberculosis--Pulmonary

The function of the pancreatic incretory apparatus was studied in 51 patients with primary active pulmonary tuberculosis by analysing the blood levels of immunoreactive insulin, C peptide and glucose before and after glucagon stimulation. A pronounced enhanced insulin secretion was found. At the same time signs of relative insulin deficiency appeared as persistent hyperglycemia and apparently delayed concentration peaks of immunoreactive insulin and C peptide. Prednisolone therapy caused a noticeable, but rapidly reversible aggravation of relative insulin deficiency. Relative insulin deficiency coupled with the higher secretory function of the pancreatic insular apparatus which decreased its functional reserves with increases in the disease duration is likely to underlie the more frequent development of severe diabetes mellitus in patients with pulmonary tuberculosis.

Topics: Adult; Blood Glucose; C-Peptide; Carbohydrate Metabolism; Diabetes Mellitus; Female; Humans; Insulin; Islets of Langerhans; Male; Middle Aged; Tuberculosis, Pulmonary

Early phase hyperglycemia, associated with increased rates of insulin and C-peptide secretion after oral administration of 100 g glucose, was observed among patients with pulmonary tuberculosis who were taking rifampicin. This early phase hyperglycemia appeared shortly after rifampicin was started and it disappeared completely a few days after rifampicin was discontinued. No difference in oral glucose tolerance was noted between healthy normal subjects and patients with pulmonary tuberculosis who were not taking any medications. Antituberculous drugs other than rifampicin did not induce early phase hyperglycemia. Because intravenous glucose tolerance was normal in patients treated with rifampicin, it is suggested that rifampicin produces an early phase hyperglycemia possibly by augmenting intestinal absorption of glucose.

Topics: Administration, Oral; Adolescent; Aged; Antitubercular Agents; Blood Glucose; C-Peptide; Food; Glucose; Glucose Tolerance Test; Humans; Hyperglycemia; Insulin; Male; Rifampin; Tuberculosis, Pulmonary