Effects of acute insulin excess and deficiency on gluconeogenesis and glycogenolysis in type 1 diabetes.

Abstract

To determine whether insulin induces acute changes in endogenous glucose production (EGP) via changes in gluconeogenesis (GNG), glycogenolysis (GL), or both, we measured GNG (with (2)H(2)O) and GL (EGP-GNG) in nine patients with type 1 diabetes during acute insulin excess produced by subcutaneous injection of insulin and during insulin deficiency which developed between 5 and 8 h after insulin injection. During insulin excess, free insulin concentration rose fivefold (from 36 to 180 pmol/l). Plasma glucose was maintained between 6.2 and 6.7 mmol/l for approximately 4 h with IV glucose. EGP (with 6,6-(2)H glucose) decreased from 17.1 to 9.8 micro mol. kg(-1). min(-1) after 1 h. This decrease was almost completely accounted for by a decrease in GL (from 10.7 to 4.6 micro mol. kg(-1). min(-1)). During insulin deficiency, plasma glucose rose from 6.2 to 10.5 mmol/l and EGP from 9.5 to 14.3 micro mol/kg min. The increase in EGP again was accounted for by an increase in GL. We conclude that in type 1 diabetes acute regulation of EGP by insulin is mainly via changes in GL while GNG changes little during the early hours of acute insulin excess or deficiency.

• Authors: Guenther Boden, Peter Cheung, Carol Homko
• Journal: Diabetes (Diabetes) Vol. 52 Issue 1 Pg. 133-7 (Jan 2003) ISSN: 0012-1797 [Print] United States
• PMID: 12502503 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Blood Glucose
• Fatty Acids, Nonesterified
• Hormones
• Insulin
• Ketone Bodies
• Lipids
• Glycogen
• Glucose

Topics

• Adult
• Blood Glucose (analysis)
• Carbohydrate Metabolism
• Diabetes Mellitus, Type 1 (metabolism)
• Dose-Response Relationship, Drug
• Fatty Acids, Nonesterified (blood)
• Female
• Gluconeogenesis (physiology)
• Glucose (administration & dosage, biosynthesis, pharmacology)
• Glycogen (metabolism)
• Hormones (blood)
• Humans
• Insulin (deficiency, metabolism)
• Ketone Bodies (blood)
• Lipids (blood)
• Male
• Oxidation-Reduction