Hyperinsulinemic response to oral glucose in obese patients with essential hypertension

Background and objectives: Hypertension is a common health problem. The prevalence of hypertension increases progressively with increasing Body Mass Index. The aim of this study is to investigate changes in blood pressure (BP), plasma glucose (PG) and insulin level after ingestion of oral glucose; and to assess the relation between insulin level and BP in obese and non-obese normo-tensive and hypertensive subjects. Materials and Methods: Seventy five g glucose dissolved in 250 ml of water was given orally to 20 fasting newly diagnosed untreated patients with essential hypertension and 15 normo-tenisve control subjects matched for age, gender and Body Mass Index (BMI). Smokers and subjects with diabetes, hyperlipidemia, cardiac or renal disease or those taking medications were excluded. Subjects were monitored for 2 hours.Half hourly BP, PG and insulin were measured. Results: Subjects were classified into obese (BMI≥ 30 Kg/m2) (11 patients, 8 normo-tensives) and nonobese (BMI< 30 Kg/m2) (9 patients, 7 normo-tensives). In obese hypertensive patients, insulin showed significant positive correlation with: systolic BP (SBP) (P=.04), diastolic BP (DBP) (P=.04) and mean BP(MBP)(P=.03). Obese hypertensive patients showed a significantly higher insulin response to oral glucose than obese normo-tensive subjects (P=.02).In obese and non-obese hypertensive patients glucose intake was associated with significant drop in DBP((P≤ .005), (P< .05)) and MBP ((P< .005), (P< .05)) respectively.Conclusions: In obese hypertensive patients, the hyperinsulinemic response to oral glucose and the positive correlation of insulin with BP suggest that insulin may be involved in development of essential hypertension especially in obese patients

Undiagnosed diabetes mellitus and impaired glucose tolerance among hypertensive patients in Mulago Hospital, Kampala, Uganda

Both diabetes and impaired glucose tolerance (IGT) are rising globally, and are known to be associated with hypertension. We have assessed the prevalence of, and risk factors for, abnormal glucose tolerance (AGT) among hypertensive patients in Kampala, Uganda. A total of 320 randomly chosen hypertensive patients were studied, demographic and other data collected, and an oral glucose tolerance test (OGTT) carried out. AGT was found in 237 (74%) patents ­ 50% had IGT and 24% type 2 diabetes. The following factors were significantly associated with AGT: body mass index (BMI) over 28.0 kg/m2 (p=0.003), family history of diabetes (p=0.002), physical inactivity (p=0.001), alcohol consumption (p=0.01), and a systolic blood pressure (BP) over 140 mmHg. We conclude that diabetes and IGT are highly prevalent in hypertensive patients and screening for these conditions in such patients should be considered

Quantitative Reference Ranges for Fasting Profiles and Oral Glucose Tolerance Test for Healthy Adults in Metropolitan Region of Nairobi; Kenya

Purpose:To establish quantitative reference ranges for fasting profiles and oral glucose tolerance test for healthy adults in metropolitan region of Nairobi. Methods: A prospective study carried out on 871 healthy subjects from the metropolitan region of Kenya. Results: The fasting profile parameters investigated were fasting blood glucose (FBG); total cholesterol (TC) triglycerides (TG); high density lipoprotein cholesterol (HDLC); low density lipoprotein cholesterol (LDLC) and TC/HDLC ratio. In addition; oral glucose tolerance test (OGTT) was also investigated. Eight hundred and seventy one (871) healthy study subjects were involved in the study. Established reference ranges were as follows: FBG (venous whole blood) (2.1 - 5.7) mmol/L; TC (2.9 - 6.4) mmol/L; TG (0.44- 2.44); HDL C (1.1 - 2.1) mmol/L; LDLC (1.1 - 4.3) mmol/L; TC/HDLC ratio (1.1 - 5.4). Established reference ranges for oral glucose tolerance test (OGTT) were as follows: baseline/fasting blood glucose capillary whole blood (3.2-5.4) mmol/L; half hour (4.7-8.9) mmol/L; one hour (4.4-9.8) mmol/L; one hour and half (4-8.1) mmol/L and two hours (3.4-7.2) mmol/L. Results for gender differences for the studied parameters were as follows: FBG (p=0.124); TC (p=0.205); TG (p=0.705) HDLC (p= 0.52); LDLC (p=0.417) and TC/HDLC ratio (p=0.359). On the other hand; the gender results for timed OGTT were as follows: 0 hour (p=0.123); half hour (p=0.479); one hour (p=0.412); one hour and half (p=0.596)) and two hours (p=0.630). Hence there were no gender disparities for the parameters in the studied adult Kenyan population. Conclusion: Since the established reference ranges are a reflection of the Kenyan adult population our clinical chemistry laboratory reports interpretations will henceforth be independent of what has been quoted in literature. Likewise effective diagnosis and management of glucose and lipids pathological disorders will be achieved by the use of established adult Kenyan reference ranges