The effects of non-insulin-dependent diabetes mellitus on the kinetics of onset of insulin action in hepatic and extrahepatic tissues
Open accessAbstract
The mechanism(s) of insulin resistance in non-insulin-dependent diabetes mellitus remains ill defined. The current studies sought to determine whether non-insulin-dependent diabetes mellitus is associated with (a) a delay in the rate of onset of insulin action, (b) impaired hepatic and extrahepatic kinetic responses to insulin, and (c) an alteration in the contribution of gluconeogenesis to hepatic glucose release. To answer these questions, glucose disappearance, glucose release, and the rate of incorporation of 14CO2 into glucose were measured during 0.5 and 1.0 mU/kg-1 per min-1 insulin infusions while glucose was clamped at approximately 95 mg/dl in diabetic and nondiabetic subjects. The absolute rate of disappearance was lower (P < 0.05) and the rate of increase slower (P < 0.05) in diabetic than nondiabetic subjects during both insulin infusions. In contrast, the rate of suppression of glucose release in response to a change in insulin did not differ in the diabetic and nondiabetic subjects during either the low (slope 30-240 min:0.02 +/- 0.01 vs 0.02 +/- 0.01) or high (0.02 +/- 0.00 vs 0.02 +/- 0.00) insulin infusions. However, the hepatic response to insulin was not entirely normal in the diabetic subjects. Both glucose release and the proportion of systemic glucose being derived from 14CO2 (an index of gluconeogenesis) was inappropriately high for the prevailing insulin concentration in the diabetic subjects. Thus non-insulin-dependent diabetes mellitus slows the rate-limiting step in insulin action in muscle but not liver and alters the relative contribution of gluconeogenesis and glycogenolysis to hepatic glucose release.
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When age-, gender-, and weight-matched groups have been compared, hepatic insulin resistance has frequently been reported to be comparable.
“but when age-, gender-, and weight-matched groups have been compared, hepatic insulin resistance has frequently been reported to be comparable.[27][28][29][30][31][32]”
From Increased liver fat, impaired insulin clearance, and hepatic and adipose tissue insulin resistance in type 2 diabetes. (2008) · cites this paper as [28]
In other studies, S-free insulin concentrations have been comparable between type 2 diabetic patients and normal subjects.
“In other studies, S-free insulin concentrations have been comparable between type 2 diabetic patients and normal subjects.28,30 -32”
From Increased liver fat, impaired insulin clearance, and hepatic and adipose tissue insulin resistance in type 2 diabetes. (2008) · cites this paper as [28]
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- Authors
- Turk, D., Alzaid, A., Dinneen, S., Nair, K. S., & Rizza, R.
- Affiliations
- Mayo Clinic (US)
- ORCID
- Venue
- Journal of Clinical Investigation
- Published
- 1995-02-01
- Volume
- 95
- Issue
- 2
- Pages
- 755-762
- ISSN
- 0021-9738 (ISSN-L)
- PMC
- PMC295544
- OpenAlex
- W2028719191
- Cited by
- 45
- References
- 50
- Citations by year
- 2025: 1 · 2023: 1 · 2017: 1 · 2016: 1 · 2015: 1 · 2013: 1 · 2012: 1
- FWCI
- 2.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Investigation (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Mayo Foundation for Medical Education and Research
- National Institute of Diabetes and Digestive and Kidney Diseases (DK 41973, DK 29953)
- National Center for Research Resources (RR-00585, M01RR000585)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, insulin resistance, hepatic glucose production, gluconeogenesis, glycogenolysis, muscle glucose uptake
- MeSH terms
- Alanine, Blood Glucose, C-Peptide, Diabetes Mellitus, Type 1, Female, Gluconeogenesis, Glucose, Glycerol, Humans, Infusions, Intravenous, Insulin, Kinetics, Lactates, Liver, Male, Middle Aged, Organ Specificity, Reference Values, Glucose Clamp Technique
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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