Pattern Of Insulin Response Research Articles

Effect of long-chain triglyceride on human insulin secretion.

The responses of blood glucose and plasma free fatty acid (FFA), triglycéride (TG) and immunoreactive insulin concentrations to the oral and intravenous administration of long-chain TG have been measured in normal subjects. A TG emulsion and an aqueous solution of glycerol were each infused intravenously over five hours on different days in six subjects. Glycerol infusion produced no measurable effect. The TG infusion did not induce changes in plasma insulin and blood glucose concentrations despite increases in plasma FFA and TG levels. Eight subjects ingested safflower oil on one occasion and water on another. Oil ingestion caused an early and significant increase in the plasma insulin concentration, which preceded any increases in plasma FFA and TG concentrations. Blood glucose levels were unchanged. In six additional subjects, the ingestion of a safflower oil emulsion, in contrast to the unemulsified oil, led to earlier and larger increases in plasma FFA and TG concentrations. Despite differences in rates of TG absorption, there was no difference in the pattern of plasma insulin and blood glucose responses to emulsified or unemulsified oil. Therefore only the oral, but not the intravenous, administration of TG stimulated insulin release, which was not related to changes in plasma FFA and TG levels. The insulin response to ingested TG may therefore reflect the release of gastrointestinal hormones, such as pancreozymin, which in turn stimulates the pancreatic islets.

Patterns of insulin response to glucose in protein-calorie malnutrition

Patterns of insulin secretion after oral or intravenous glucose, or both, have been studied in 54 children with protein-calorie malnutrition. Generally the immunoreactive insulin curve is flat, corresponding to a gross quantitative deficiency. However, in certain patients, insulin secretion is sustained or delayed after oral or intravenous glucose. The sustained response may represent insulin antagonism. The delayed peak after oral glucose administration is possibly due to a deficiency in gut beta-cytotrophic factors that recover on treatment. This is suggested by a much greater increase, after improvement in nutritional status, of insulin-glucose ratios in response to oral rather than intravenous glucose when similar glycemic stimuli are achieved. However, a disturbance of other factors thought to participate in the mediation of normal insulin release may play an additional ce:role.

Insulin levels in Nigerian adults, children and pregnant women.

Immunoreactive insulin (IRI) has been measured in a group of Nigerians. In 39 adults, 23 children and 34 pregnant women, IRI in morning blood samples showed high mean fasting levels which may be related to the traditional highcarbohydrate diet. Fasting plasma insulin levels were all below 53 µu/ml and values in males and non-pregnant women were respectively higher than in females and pregnant subjects. The values in children were noticeably higher than those reported from elsewhere and no progressive rise in plasma insulin with age was observed. Following an oral glucose dose in 32 adults, delayed maximal insulin response was generally observed. In 25% the pattern of insulin response was indicative of prediabetes. However, it is suggested that this rather high prediabetic rate may not represent the true incidence of the condition but may be partly influenced by gastrointestinal factors which may be peculiar to subjects in the environment.

The Pattern of Plasma Insulin Response to Glucose in Patients with a Previous Myocardial Infarction-The Respective Effects of Age and Disease.

Plasma insulin and blood sugar variations were investigated during oral (OGTT) and intravenous (IVGTT) glucose tolerance tests in 10 patients aged 32 to 41 and 10 Patients aged 48 to 60 who had suffered a myocardial infarction at least three months previously. The results obtained in each group of patients were compared with those of ten normal subjects of corresponding age. The respective influences of age and cardio-vascular disease on the pattern of the plasma insulin and blood sugar responses to the glucose load were dissociated on the basis of analysis of variance.-Advancing age was associated with a rise in the mean blood sugar level during OGTT and a lowering of the glucose assimilation coefficient during IVGTT, but it was not accompanied by a significant change in the plasma insulin levels during either of the two tests.-Cardiovascular disease was associated with an augmentation of the mean blood sugar level during OGTT, but also with a prolonged and excessive response in plasma insulin. During IVGTT the glucose assimilation coefficient and the plasma insulin variations were not statistically different in the patients with a previous myocardial infarction and in the normal subjects.-The previous occurrence of a myocardial infarction is thus associated with a hyperinsulinism during OGTT, but not after a rapid stimulation as realized during IVGTT. The nature of the gastrointestinal factors involved in the genesis of this hyperinsulinism remains a matter of conjecture.

Diabetes in patients treated with asparaginase.

In 5 patients treated with L‐asparaginase, plasma insulin response to intravenous glucose injection was measured by radioimmunoassay. Two of the patients developed a diabetic state (2 and 4 days) after a single dose of L‐asparaginase, while a third patient developed diabetes 2 days after the fourth dose of L‐asparaginase. Plasma insulin was not detectable by radioimmunoassay during the diabetic state in each of them. The normal pattern of insulin response returned completely in one of the 3 patients within 23 days, whereas suboptimal response persisted for 2 weeks and 9 months in the remaining 2 patients. The two remaining patients were studied prior to and 6 days after a single dose of L‐asparaginase; neither developed a diabetic state.

Glucose and insulin secretory response patterns following diet and tolazamide therapy in diabetes.

Glucose and insulin secretory response patterns during glucose tolerance tests were determined in 28 maturity-onset diabetics, and the sequential effects of diet and a sulphonylurea, tolazamide, were assessed. Untreated diabetics showed hyperglycaemia, increased serum immunoreactive insulin response patterns, delayed insulin release, and relative insulin deficiency. Diet alone partially corrected the hyperglycaemia and serum immunoreactive insulin response but had no effect on the delayed insulin release or relative insulin deficiency. Tolazamide plus diet restored all values towards normal. The net effect of maintenance tolazamide therapy was to (1) restore the insulin secretory response pattern to normal, (2) reduce total pancreatic insulin output, and (3) improve the efficiency of insulin secretion. The results suggest that there is a rational basis for the use of sulphonylurea in all maturity-onset diabetics, including patients with mild carbohydrate intolerance and those who are apparently controlled by diet alone.

Progesterone, pregnancy and the augmented plasma insulin response.

ABSTRACT Intramuscular progesterone, 300–400 mg, was given daily to 5 normal men and to 2 hysterectomized women for 6 days to assess the role of this steroid in the development of hyperinsulinemia observed during pregnancy. Twentyfour hr urinary pregnanediol excretion increased to levels that were within the range of late gestation. On days 5 and 6 plasma glucose concentrations during oral glucose and intravenous tolbutamide tolerance tests were unchanged, but plasma insulin responses including fasting levels were significantly increased above control values. Patterns of insulin response were similar to those measured during studies of 10 normal women in late pregnancy. Progesterone effects were independent of any changes in fasting plasma glucose, free fatty acids, serum cortisol or immunoreactive growth hormone. These results suggest that progesterone, like pregnancy, evokes an enhanced plasma insulin response to insulinogenic stimuli as pancreatic islet adjustment to peripheral insulin antagonism evolv...

The role of human chorionic somatomammotropin (HCS) and gonadal steroids in gestational diabetes.

Maternal carbohydrate tolerance during gestation appears to be altered by at least two mechanisms: 1) decreased sensitivity of insulin-sensitive tissues to the hypoglycemic action of insulin, and 2) alterations in the sensitivity of the islets of Langerhans to the insulinogenic stimulus of glucose. The effect of physiologic amounts of unconjugated estriol and estradiol on these parameters is as yet unknown. Decreased sensitivity to insulin can be produced experimentally in female Rhesus monkeys by human chorionic somatomammotropin (HCS) and by progesterone administration. Progesterone administration enhances glucose-stimulated insulin production in both monkeys and man. By contrast, HCS administration reverses the progesterone-enhanced serum insulin response to glucose in monkeys and actually retards insulin production in response to glucose in subclinical diabetic women. The latter pattern of insulin response is similar to, but not identical with, that seen in women with gestational diabetes. Whether progesterone and/or the estrogens elaborated by the conceptus alter the effect of HCS on insulin production or sensitivity to insulin in normal or subclinical diabetic women remains to be determined.

Normal and Diabetic Patterns of Insulin Response to Glucose

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