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Greater efficacy of pulsatile insulin in type I diabetics critically depends on plasma glucagon levels.
Paolisso, G.; Sgambato, S.; Passariello, N. et al.
1987In Diabetes, 36 (5), p. 566-70
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Keywords :
Adult; Blood Glucose/metabolism; Diabetes Mellitus, Type 1/blood/drug therapy; Female; Glucagon/blood/diagnostic use; Humans; Infusions, Intravenous; Insulin/administration & dosage/blood/therapeutic use; Kinetics; Male; Somatostatin/diagnostic use
Abstract :
[en] The aim of this study was to investigate the role of plasma glucagon levels on the blood glucose response to intravenous insulin administered continuously or in a pulsatile manner. Six type I diabetic patients proven to have no residual insulin secretion were investigated. Endogenous glucagon secretion was inhibited by a continuous intravenous infusion of somatostatin (100 micrograms/h) and replaced by exogenous infusions of the hormone at three different rates (7.5, 4.5, and 2.5 micrograms/h), resulting in three different plasma glucagon steady-state levels (i.e., approximately equal to 200, approximately equal to 130, and approximately equal to 75 pg/ml, respectively). Each subject, in random order and on different days, was infused intravenously with regular human insulin either continuously (0.17 mU X kg-1 X min-1) or with the same amount of insulin infused in a pulsatile manner (0.85 mU X kg-1 X min-1 during 2 min followed by 8 min during which no insulin was infused). At plasma glucagon levels approximately equal to 200 pg/ml, blood glucose rose from approximately 10 to approximately 13 mM without any difference between the two modalities of insulin infusion. For plasma glucagon levels approximately equal to 130 pg/ml, plasma glucose remained steady throughout the experiments, but during the last 40 min, plasma glucose levels were significantly lower when insulin was administered intermittently. This greater blood glucose-lowering effect of pulsatile insulin occurred earlier and was more pronounced for plasma glucagon levels averaging 75 pg/ml. We conclude that the greater hypoglycemic effect of insulin administered intravenously in a pulsatile manner in type I diabetics critically depends on plasma glucagon circulating levels.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Paolisso, G.
Sgambato, S.
Passariello, N.
Scheen, André  ;  Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale
D'Onofrio, F.
Lefebvre, Pierre ;  Centre Hospitalier Universitaire de Liège - CHU > Diabétologie,nutrition, maladies métaboliques
Language :
English
Title :
Greater efficacy of pulsatile insulin in type I diabetics critically depends on plasma glucagon levels.
Publication date :
1987
Journal title :
Diabetes
ISSN :
0012-1797
eISSN :
1939-327X
Publisher :
American Diabetes Association, Alexandria, United States - Virginia
Volume :
36
Issue :
5
Pages :
566-70
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 08 June 2009

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