Assessment of insulin action in insulin-dependent diabetes mellitus using [614C]glucose, [33H]glucose, and [23H]glucose. Differences in the apparent pattern of insulin resistance depending on the isotope used

P. M. Bell, R. G. Firth, R. A. Rizza

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87 Scopus citations

Abstract

To determine whether [23H], [33H], and [614C]glucose provide an equivalent assessment of glucose turnover in insulin-dependent diabetes mellitus (IDDM) and nondiabetic man, glucose utilization rates were measured using a simultaneous infusion of these isotopes before and during hyperinsulinemic euglycemic clamps. In the nondiabetic subjects, glucose turnover rates determined with [614C]glucose during insulin infusion were lower (P < 0.02) than those determined with [23H]glucose and higher (P < 0.01) than those determined with [33H]glucose. In IDDM, glucose turnover rates measured with [614C]glucose during insulin infusion were lower (P < 0.05) than those determined with [23H]glucose, but were not different from those determined with [33H]glucose. All three isotopes indicated the presence of insulin resistance. However, using [33H]glucose led to the erroneous conclusion that glucose utilization was not significantly decreased at high insulin concentrations in the diabetic patients. [614C] and [33H]glucose but not [23H]glucose indicated impairment in insulin-induced suppression of glucose production. These results indicate that tritiated isotopes do not necessarily equally reflect the pattern of glucose metabolism in diabetic and nondiabetic man.

Original languageEnglish (US)
Pages (from-to)1479-1486
Number of pages8
JournalJournal of Clinical Investigation
Volume78
Issue number6
DOIs
StatePublished - 1986

ASJC Scopus subject areas

  • General Medicine

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