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Differential Metabolic Actions of Biosynthetic Insulin Analogues in Normal Man Assessed by Stable Isotopic Tracers
Abstract
Insulin analogues have been produced with high affinity for the insulin receptor and with affinity lower than that of native insulin, but differences in activity when administered in vivo to man are unconvincing. We have used very low dose insulin (0.005 units kg−1 h−1) to investigate possible differences in effect of these insulin analogues on lipolysis in seven healthy subjects. Only minor effects on blood glucose concentration were observed and glucose turnover measured isotopically with 6,6 2 H glucose and leucine turnover measured with 1−13 C leucine did not change significantly. Fatty acid levels decreased with insulin (area under curve, median (range) −23 (‐41–10) mmol l−1 h) and with the low affinity analogue (‐28 (‐42–19) mmol l−1 h), but the high affinity analogue had no significant effect compared with controls (high affinity analogue −8 (‐28–35) mmol l−1 h; control +15 (11–53) mmol l−1 h). Glycerol production measured isotopically decreased with insulin (‐0.54 (‐1.50–0.63) μmol kg−1 min−1) and with the low affinity analogue (‐0.74 (‐1.76–0.72) μmol kg−1 min−1), but the high affinity analogue at these doses had no significant effect on glycerol turnover (‐0.19 (‐0.74–1.13) μmol kg−1 min−1). Thus at these low infusion rates insulin itself and the low affinity analogue suppressed lipolysis, as assessed by glycerol turnover and by circulating fatty acid concentrations. The high affinity analogue was cleared rapidly from the circulation producing no measurable increase in immunoreactive insulin concentrations, and no effect was observed on lipolysis.
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Lipolysis is more sensitive to small changes in insulin concentration than EGP, and plasma NEFA levels are closely correlated with changes in lipolysis.
“As lipolysis is more sensitive to small changes in insulin concentration than EGP [35, 36], and plasma NEFA levels are closely correlated with changes in lipolysis”
From Low-dose glucocorticoid treatment affects multiple aspects of intermediary metabolism in healthy humans: a randomised controlled trial (2011) · cites this paper as [36]
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van Raalte, D. H., Brands, M., van der Zijl, N. J., Muskiet, M. H., Pouwels, P. J. W., Ackermans, M. T., Sauerwein, H. P., Serlie, M. J., & Diamant, M. (2011) · Diabetologia · doi:10.1007/s00125-011-2174-9 · Cited by 109
“Prednisolone 30 mg, an induction dosage often used in the clinic for short-term treatment, impaired the effects of insulin on EGP, glucose disposal and lipolysis to a greater extent than prednisolone 7.5 mg.”
BackgroundInfluential
Metadata
- Authors
- Gelding, S. V., Coldham, N., Anyaoku, V., Heslop, K., Halliday, D., & Johnston, D. G.
- Affiliations
- St Mary's Hospital (GB)
- Corresponding author
- Gelding, S. V.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 1993-06
- Volume
- 10
- Issue
- 5
- Pages
- 470-476
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W1981639657
- Cited by
- 4
- References
- 37
- FWCI
- 0.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
- Keywords
- insulin analogues, insulin receptor affinity, lipolysis, glycerol turnover, fatty acid levels, glucose turnover, leucine turnover, insulin clearance
- MeSH terms
- Adult, Blood Glucose, Carbon Isotopes, Deuterium, Fatty Acids, Nonesterified, Female, Glycerol, Humans, Insulin, Lipolysis, Male, Recombinant Proteins, Reference Values
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