Abstract

The role of insulin in the control of somatomedin release has been investigated in people with Type 1 diabetes. Six patients underwent insulin-induced hypoglycaemia of 20 min duration and 8 patients were studied using the hyperinsulinaemic euglycaemic clamp technique at insulin infusion rates of 0.25, 1.25, 2.5, and 0.25 mU kg-1 min-1 for 1 h at each rate. In the first study plasma insulin concentrations rose from (median, range) 23 (10-36) to 114(60-200) mU l-1 at the onset of hypoglycaemia, and fell to 53 (23-100) mU l-1 after 20 min hypoglycaemia and 30 (15-73) mU l-1 on return to normoglycaemia. Plasma IGF-1 rose from 140 (96-292) to 179 (127-352) micrograms l-1 (p less than 0.05) at the onset of hypoglycaemia and fell to 131 (125-173) micrograms l-1 after 20 min and to 154 (121-287) micrograms l-1 at the end of the study. During hyperinsulinaemia plasma insulin rose from 23 (19-40) mU l-1 at the lowest infusion rate to 61 (33-84) and 148 (68-200) mU l-1 at the two higher infusion rates. Over the same period, plasma IGF-1 increased from 91 (13-203) to 123 (98-182) micrograms l-1 (p less than 0.05) and 109 (84-160) micrograms l-1. There was no correlation between growth hormone levels and IGF-1 in either study. These results suggest that insulin produces short-term increases in IGF-1 levels in man in the absence of a growth hormone response.

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