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Improved insulin sensitivity in patients with type I diabetes mellitus after CSII.
Diabetes. 1985 Aug; 34 Suppl 3:80-6.D

Abstract

Tissue sensitivity to insulin was studied using the euglycemic insulin clamp technique (delta plasma insulin above basal 90 microU/ml) in eight patients with type I diabetes mellitus (IDDM) before and after 4-8 mo of continuous subcutaneous insulin infusion (CSII) and in 36 age-matched control subjects. Institution of CSII was associated with significant improvements in glycosylated hemoglobin (HbA1) (11.2 +/- 0.6% versus 8.1 +/- 0.4%; P less than 0.001) and mean 24-h plasma glucose concentrations (239 +/- 23 mg/dl versus 106 +/- 18 mg/dl; P less than 0.001). Insulin-mediated glucose metabolism in the diabetic patients pre-CSII (3.92 +/- 0.36 mg/kg X min) was reduced by 44% compared with controls (7.03 +/- 0.22 mg/kg X min; P less than 0.001). After 4-8 mo of improved glycemic control, improved tissue sensitivity to insulin was observed (5.33 +/- 0.75 mg/kg X min; P less than 0.05 versus pre-CSII). However, insulin-mediated glucose utilization still remained significantly below control values (P less than 0.01). During hyperinsulinemia, hepatic glucose production (3-3H-glucose) was suppressed by over 90% in diabetic patients (pre- and post-CSII) and in control subjects. We conclude that near-normalization of glucose metabolism with CSII partially corrects, but does not restore to normal, insulin-stimulated glucose uptake in IDDM. Our failure to totally reverse the impaired response of peripheral tissues to insulin in IDDM patients may be attributed to inadequate metabolic correction, the peripheral route of insulin administration, or a primary defect in glucose metabolism.

Authors

Simonson DC
No affiliation info available
Tamborlane WV
No affiliation info available
Sherwin RS
No affiliation info available
Smith JD
No affiliation info available
DeFronzo RA
No affiliation info available

MeSH

Blood GlucoseDiabetes Mellitus, Type 1HumansInjections, SubcutaneousInsulinInsulin Infusion SystemsInsulin ResistanceMonocytes

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

3894130

Citation

Simonson, D C., et al. "Improved Insulin Sensitivity in Patients With Type I Diabetes Mellitus After CSII." Diabetes, vol. 34 Suppl 3, 1985, pp. 80-6.
Simonson DC, Tamborlane WV, Sherwin RS, et al. Improved insulin sensitivity in patients with type I diabetes mellitus after CSII. Diabetes. 1985;34 Suppl 3:80-6.
Simonson, D. C., Tamborlane, W. V., Sherwin, R. S., Smith, J. D., & DeFronzo, R. A. (1985). Improved insulin sensitivity in patients with type I diabetes mellitus after CSII. Diabetes, 34 Suppl 3, 80-6.
Simonson DC, et al. Improved Insulin Sensitivity in Patients With Type I Diabetes Mellitus After CSII. Diabetes. 1985;34 Suppl 3:80-6. PubMed PMID: 3894130.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improved insulin sensitivity in patients with type I diabetes mellitus after CSII. AU - Simonson,D C, AU - Tamborlane,W V, AU - Sherwin,R S, AU - Smith,J D, AU - DeFronzo,R A, PY - 1985/8/1/pubmed PY - 1985/8/1/medline PY - 1985/8/1/entrez SP - 80 EP - 6 JF - Diabetes JO - Diabetes VL - 34 Suppl 3 N2 - Tissue sensitivity to insulin was studied using the euglycemic insulin clamp technique (delta plasma insulin above basal 90 microU/ml) in eight patients with type I diabetes mellitus (IDDM) before and after 4-8 mo of continuous subcutaneous insulin infusion (CSII) and in 36 age-matched control subjects. Institution of CSII was associated with significant improvements in glycosylated hemoglobin (HbA1) (11.2 +/- 0.6% versus 8.1 +/- 0.4%; P less than 0.001) and mean 24-h plasma glucose concentrations (239 +/- 23 mg/dl versus 106 +/- 18 mg/dl; P less than 0.001). Insulin-mediated glucose metabolism in the diabetic patients pre-CSII (3.92 +/- 0.36 mg/kg X min) was reduced by 44% compared with controls (7.03 +/- 0.22 mg/kg X min; P less than 0.001). After 4-8 mo of improved glycemic control, improved tissue sensitivity to insulin was observed (5.33 +/- 0.75 mg/kg X min; P less than 0.05 versus pre-CSII). However, insulin-mediated glucose utilization still remained significantly below control values (P less than 0.01). During hyperinsulinemia, hepatic glucose production (3-3H-glucose) was suppressed by over 90% in diabetic patients (pre- and post-CSII) and in control subjects. We conclude that near-normalization of glucose metabolism with CSII partially corrects, but does not restore to normal, insulin-stimulated glucose uptake in IDDM. Our failure to totally reverse the impaired response of peripheral tissues to insulin in IDDM patients may be attributed to inadequate metabolic correction, the peripheral route of insulin administration, or a primary defect in glucose metabolism. SN - 0012-1797 UR - https://www.unboundmedicine.com/medline/citation/3894130/Improved_insulin_sensitivity_in_patients_with_type_I_diabetes_mellitus_after_CSII_ DB - PRIME DP - Unbound Medicine ER -