|Reference : Greater efficacy of pulsatile insulin in type I diabetics critically depends on plasma g...|
|Scientific journals : Article|
|Human health sciences : Endocrinology, metabolism & nutrition|
|Greater efficacy of pulsatile insulin in type I diabetics critically depends on plasma glucagon levels.|
|Paolisso, G. [> > > >]|
|Sgambato, S. [> > > >]|
|Passariello, N. [> > > >]|
|Scheen, André [Université de Liège - ULg > 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 >]|
|American Diabetes Association|
|[en] 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|
|[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.|
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