Infusion Of Porcine Insulin Research Articles

Effects of insulin and hypoglycemia on the auditory brain stem response in humans

1. This study aimed to differentiate effects of insulin and hypoglycemia on sensory brain stem functions in humans. Auditory brain stem responses (ABR) were examined in 30 healthy men during euglycemia and after 20 and 50 min of steady-state hypoglycemia of 2.6 mM induced with human insulin (HI) in one session and porcine insulin (PI) in another session. 2. Levels of blood glucose and serum insulin were identical in both sessions during HI and PI infusion. 3. Hypoglycemia increased interpeak latencies III-V (+71 microseconds; P < 0.001) and I-V (+123 microseconds; P < 0.001), whereas changes in the latency of wave I were not significant. 4. After 20 min of constant hypoglycemia, increases in the interpeak latencies I-V and III-V were significantly more pronounced during infusion of PI than HI. These differences disappeared with time spent in hypoglycemia, i.e., after 50 min of hypoglycemia. 5. Apart from the delaying effect of hypoglycemia on neuronal transmission within the sensory brain stem, the results provide evidence for a separate influence of insulin on these functions.

Vanadyl sulfate prevents fructose-induced hyperinsulinemia and hypertension in rats.

To determine whether insulin resistance and hyperinsulinemia are causally related to fructose-induced hypertension, we used vanadyl sulfate, a drug that improves insulin sensitivity in rats. Chronic oral vanadyl treatment was initiated in 6-week-old male Sprague-Dawley rats. One week after vanadyl was started, rats were fed either normal rat chow or a fructose-enriched diet. Plasma glucose and insulin levels and systolic blood pressure were measured weekly for 4 weeks. Fructose feeding induced hyperinsulinemia (fructose-fed, 366.6 +/- 8.4 versus control, 276 +/- 10.8 pmol/L, P < .001) and increased blood pressure (fructose-fed, 160 +/- 3.0 versus control, 124 +/- 3.0 mm Hg, P < .001). Vanadyl (0.4 to 0.6 mmol/kg per day) prevented the rise in plasma insulin (treated, 211.2 +/- 6.0 pmol/L, P < .001) and blood pressure (treated, 127 +/- 3.0 mm Hg, P < .001) in the fructose-fed rats without a change in plasma glucose. No change in blood pressure was seen in the control group. After 4 weeks, euglycemic clamps were performed on 20-hour fasted, conscious, mobile rats. Low-dose porcine insulin infusion (14 pmol/kg per minute) with concomitant somatostatin infusion resulted in similar steady-state plasma glucose and insulin levels in the various groups. Hepatic glucose production was suppressed and similar among various groups under clamp conditions. Insulin sensitivity index (micromoles of glucose per kilogram per hour per picomole per liter of insulin) was reduced in the fructose-fed rats compared with controls (fructose-fed, 0.9 +/- 0.4 versus control, 5.4 +/- 1.2, P < .002).(ABSTRACT TRUNCATED AT 250 WORDS)

Intraportal hyperinsulinemia decreases insulin-stimulated glucose uptake in the dog

Hyperinsulinemia and insulin resistance are commonly seen in obese and non-insulin-dependent diabetes mellitis (NIDDM) patients. While it is known that chronic exposure to severe hyperinsulinemia can lead to an insulin-resistant state and mild hyperinsulinemia for rather short durations (20 to 40 hours) and can also lead to insulin resistance, it is less clear whether mild hyperinsulinemia for a more prolonged duration can lead to insulin resistance. In the present study we determined the effects of chronic (28 days) exposure to mild hyperinsulinemia on insulin-stimulated glucose use. Chronic hyperinsulinemia was produced by an intraportal infusion of porcine insulin (425 μU/kg/min), which raised the basal peripheral insulin levels by approximately 50%. Insulin responsiveness was assessed using the euglycemic hyperinsulinemic clamp (2 mU/kg/min) in dogs before the induction of chronic hyperinsulinemia (day 0), after 28 days of hyperinsulinemia (day 28), and 28 days after discontinuation of the chronic insulin infusion (day 56). The amount of glucose (M) required to maintain euglycemia during the euglycemic hyperinsulinemic clamp was decreased (relative to day 0) 39% ± 3% on day 28 and 18% ± 3% on day 56 ( P < .05). In control animals that received a chronic infusion of saline for the 28-day period the glucose infusion rate (M) was not changed significantly (decreasing 2% ± 5% and 5% ± 10% on days 28 and 56, respectively). In conclusion insulin resistance can be produced by a mild hypersecretion of insulin and discontinuation of the chronic insulin infusion tends to reverse the resistance.

Combined effect of exogenous insulin and sucrose on alterations in plasma lipoproteins induced by cholesterol feeding in the rat

We have recently reported increased cholesterol concentrations in high-density and very-low-density lipoproteins (HDL and VLDL) in sucrose-fed rats with exogenous hyperinsulinemia. In order to see if exogenous hyperinsulinemia has any effect on the alterations in plasma lipoproteins induced by cholesterol feeding, we fed a cholesterol-rich diet supplemented with lard, cholic acid and propylthiouracil to hyperinsulinemic, sucrose-supplemented rats and examined plasma lipoprotein profiles. Three control groups were investigated: one receiving chow only, the other receiving a cholesterol-rich diet, the third receiving exogenous insulin, sucrose, and no cholesterol-rich diet but chow. Hyperinsulinemia was induced by a constant s.c. infusion of porcine insulin (6 U/day) from an osmotic minipump. Insulin infusion plus sucrose produced an increase in HDL cholesterol concentrations similar to that seen in the previously reported injection model in the face of no change in total and low-density lipoprotein (LDL) cholesterol. Rats receiving a cholesterol-rich diet but no insulin developed marked hypercholesterolemia characterized by an elevation of cholesterol not only in LDL but also in intermediate-density lipoprotein (IDL) and VLDL. Infusing insulin into cholesterol-fed rats produced a further increase in IDL and VLDL cholesterol but was not accompanied by any further increase in LDL cholesterol. HDL cholesterol was decreased below normal. The present studies have revealed that dietary cholesterol increases cholesterol concentrations not only in LDL but in triglyceride-rich lipoproteins, the latter being further increased by exogenous hyperinsulinemia. They also demonstrate that a combination of hyperinsulinemia, sucrose and cholesterol feeding is a useful tool in producing cholesterol-rich VLDL and IDL in rat plasma.

Kinetic models for plasma disappearance of insulin in normal subjects.

Three theoretical kinetic models for plasma disappearance of insulin were examined in six normal men. The models allowed for the existence of non-saturable and/or saturable mechanisms. Constant infusion of porcine insulin at different rates was used to achieve different levels of steady state plasma insulin concentrations, while normoglycaemia was secured by a glucose clamp technique. Appropriate validation procedures demonstrated that one of the three models was superior to the others in describing the relationship between the exogenous insulin infusion rate Iex and the steady state plasma insulin concentration C: Iex = -Iend + k2 X C/(k3 + C), where Iend is the endogenous post-hepatic insulin delivery rate. Thus, only saturable mechanism(s) could be demonstrated. The median value of k2 (the maximal insulin disappearance rate) and k3 (the plasma insulin concentration at which the insulin disappearance rate is half maximal) were 7.31 nmol X min.-1 and 3.89 nmol X 1-1. The median value of k2/k3 (the clearance rate of insulin for infinitesimal plasma insulin concentrations) was 25.0 ml X kg-1 X min.-1. Thus, at physiological levels of plasma insulin concentrations the metabolic clearance rate of insulin is higher than insulin clearance estimates previously reported in studies based on the assumption of first order kinetics.

Direct assessment of splanchnic uptake and metabolic effects of human and porcine insulin.

The hepatic vein catheterization technique was used to quantitate the splanchnic uptake and the metabolic effects of biosynthetic human insulin (BHI) and porcine insulin (PI) in normal man. BHI and PI were infused into a peripheral vein (0.9-1.3 mU kg-1 min-1) for 60 min together with SRIH (0.6 mg/h) to inhibit endogenous insulin secretion and glucose to induce moderate hyperglycemia (9-10 mmol/liter). During the infusion period, arterial-hepatic venous difference of plasma C-peptide as well as splanchnic C-peptide output fell by more than 98% indicating virtually complete cessation of endogenous insulin release. Under these conditions, the arterial-hepatic venous differences in plasma insulin concentrations represent a valid and direct measurement of splanchnic insulin uptake. During BHI infusion, arterial insulin levels rose to 82 +/- 11 (SE) microU/ml (range: 33-105 microU/ml). Splanchnic insulin uptake paralleled the rise of arterial insulin, reaching 430 +/- 72 microU kg-1 min-1 at 60 min. No appreciable difference between BHI and PI was demonstrable. A highly significant correlation between arterial insulin concentrations and splanchnic insulin uptake was found (r = 0.816; P less than 0.001). Accordingly, both fractional splanchnic insulin extraction and splanchnic insulin clearance remained unchanged throughout insulin infusion and averaged 70 +/- 4% and 5.3 +/- 2 ml kg-1 min-1, respectively. With BHI infusion, splanchnic glucose balance (-8.5 +/- 0.9 mumol kg-1 min-1, basal) became positive (7.3 +/- 1 mumol kg-1 min-1). In contrast, basal splanchnic lactate uptake was inhibited by BHI and there was lactate production (from 3.4 +/- 0.9 to -1.7 +/- 1.4 mumol kg-1 min-1). Similar changes in splanchnic glucose and lactate metabolism occurred during PI infusion. These studies indicate that: 1) A considerable amount of insulin (70 +/- 4%) is extracted by the splanchnic bed on a single passage, after exogenous administration of either human insulin or PI; 2) over a physiological range of insulin concentrations (33-105 microU/ml) a linear relationship exists between arterial insulin concentrations and splanchnic insulin removal; and 3) BHI and PI do not differ appreciably with respect to their uptake and metabolic effects at the splanchnic level.

Differential Response to Infusions of Highly Purified and Conventional Bovine and Porcine Insulins

The glucose clamp technique allows quantification of tissue sensitivity to insulin without modulation by the effects of hypoglycemia. The amount of glucose infused to maintain euglycemia during an insulin infusion gives a direct measure of tissue sensitivity. We have used this technique to compare the metabolic effects of highly purified porcine, highly purified bovine, and conventional insulins in diabetic subjects: (A) a group normally taking conventional bovine insulin, and (B) diabetics who had originally been treated with conventional bovine insulin and had changed to highly purified porcine insulin. Subjects were studied while attached to Biostator with blood glucose values clamped at the basal level during a 2-h insulin infusion (0.01 U/kg/h). both groups of diabetics received significantly more glucose in the first hour of the monocomponent porcine insulin infusion than during the same period either of conventional or highly purified bovine insulin infusion. Highly purified porcine insulin infusion was also associated with a more rapid fall in blood ketone body concentrations. Highly purified porcine insulin infusion was accompanied by a greater and earlier increase in free insulin concentrations. All diabetics had antibodies to insulin but no differential antibody binding of beef and pork insulin was found in the two groups of patients. Thus, use of highly purified porcine insulin is associated with a more rapid onset of action and a greater initial increment in free insulin values.

Insulin metabolism in depancreatized dogs during hemorrhagic shock.

This study was done to determine why the plasma insulin remained elevated during shock. Mongrel Female dogs (12-15 kg) were depancreatized and maintained on a constant intraportal infusion of porcine insulin while they were bled to reduce and maintain the mean arterial blood pressure at 50 mm Hg for 165 min. Blood samples were taken for glucose and plasma insulin at 15 min intervals. The data show that there was a progressive rise of plasma insulin during the course of hemorrhagic shock. This occurred despite a constant infusion of insulin, the sole source of insulin available to these depancreatized dogs. Since removal of plasma insulin is largely due to insulin utilization, our findings imply that the rise of plasma insulin in hemorrhagic shock is caused by decreased utilization.

Insulin sensitivity of isolated perfused rat liver.

The responsiveness of the isolated perfused rat liver to different metabolic effects of insulin was investigated during recycling perfusion. Infusion of porcine insulin at rates of 6, 9, 16 and 33 mU/hr. resulted in stable perfusate insulin levels averaging 41, 72, 120 and 229 muU/ml., respectively. Since the portal vein insulin concentration in the intact rat averaged 48 muU/ml. after a twenty-six-hour fast and 125 muU/ml. two hours after removal of food, the studies were conducted at insulin levels within the physiological range. The effect of each insulin concentration on the net accumulation of K+, AMINO ACID NITROGEN, UREA NITROGEN AND GLUCOSE IN The perfusing medium was assessed against the net accumulation of perfusate constituents during perfusion of control livers and livers perfused with perfusate insulin levels greater than 500 muU/ml. The results indicate that essentially maximal suppression of amino acid nitrogen outflow and retention of K+ OCCURRED AT INSULIN CONCENTRAtions of 72 muU/ml., with lesser effects being noted at 41 muU/ml. Inhibition of ureogenesis was demonstrated at insulin levels above 120 muU/ml. However, significant effects of insulin on suppressing net glucose outflow was not observed until insulin levels had reached 500 muU/ml. due presumably to the absence of a sustained rate of glycogenolysis by control livers. The observation that perfused livers from normal rats are extremely sensitive to several metabolic effects of insulin at physiological concentrations suggests that this experimental approach can provide useful information as to the role of the liver in the pathogenesis of various insulin resistant states.

Prolonged suppression of insulin release by insulin-induced hypoglycemia: demonstration by C-peptide assay.

Pancreatic beta cells secrete the proinsulin connecting peptide (C-peptide) and insulin on an equimolar basis. The C-peptide can thus be used as an indicator of endogenous insulin secretion in the presence of exogenously administered insulin. Using this approach, we have shown suppression of endogenous insulin release in healthy subjects during hypoglycemia induced by intravenous infusion of porcine insulin. Moreover, the suppression persists after the plasma glucose returns to fasting levels, suggesting that the recovery of beta cells from the effects of hypoglycemia is not immediate.