Overnight normalization of glucose concentrations improves hepatic but not extrahepatic insulin action in subjects with type 2 diabetes mellitus

Steven D. Wise, Michael F. Nielsen, Philip E. Cryer, R. A. Rizza

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Subjects with poorly controlled type 2 diabetes are both hyperglycemic and insulin resistant. To determine whether short term restoration of normoglycemia improves insulin action, hyperinsulinemic (~300 pmol/L) euglycemic clamps were performed in diabetic subjects after either overnight infusion of saline or overnight infusion of insulin in amounts sufficient to maintain euglycemia throughout the night. Fasting glucose concentrations (5.2 ± 0.2 vs. 11.9 ± 1.4 mmol/L; P < 0.01) and rates of endogenous glucose production (13.0 ± 1.1 vs. 18.6 ± 1.6 μmol/kg · min; P < 0.05) were both lower after overnight insulin than overnight saline. Insulin-induced stimulation of glucose uptake (to 34.9 ± 6.8 vs. 28.8 ± 3.4 μmol/kg · min; P = 0.2) and inhibition of free fatty acids (to 0.13 ± 0.03 vs. 0.12 ± 0.04 mmol/L; P = 0.6) did not differ after overnight saline and overnight insulin. In contrast, endogenous glucose production during the final hour of the hyperinsulinemic clamps (i.e. when glucose concentrations were the same) remained higher (P = 0.05) after overnight saline than after overnight insulin (5.5 ± 1.5 vs. 0.02 ± 1.4 μmol/kg · min). Thus, acute restoration of euglycemia by means of an overnight insulin infusion improves hepatic (and perhaps renal) but not extrahepatic insulin action.

Original languageEnglish (US)
Pages (from-to)2461-2469
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume83
Issue number7
DOIs
StatePublished - 1998

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Medical problems
Type 2 Diabetes Mellitus
Insulin
Glucose
Liver
Clamping devices
Restoration
Glucose Clamp Technique
Nonesterified Fatty Acids
Fasting
Kidney

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Overnight normalization of glucose concentrations improves hepatic but not extrahepatic insulin action in subjects with type 2 diabetes mellitus. / Wise, Steven D.; Nielsen, Michael F.; Cryer, Philip E.; Rizza, R. A.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 83, No. 7, 1998, p. 2461-2469.

Research output: Contribution to journalArticle

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