Alterations in immunoreactive proinsulin and insulin clearance induced by weight loss in NIDDM
Abstract
Subjects with overt non-insulin-dependent diabetes mellitus (NIDDM) were studied in comparison to obese nondiabetic control subjects and patients with subclinical diabetes. Pancreatic insulin secretion rates were measured by deconvolution of peripheral C-peptide over a 24-h period while subjects consumed an isocaloric mixed diet. Subjects were then placed on caloric restriction for at least 6 weeks, during which time body weight fell by at least 10%. Refeeding with solid mixed meals was then resumed for at least 2 weeks until isocaloric intake was attained, and then the meal profiles were repeated. Before weight loss, insulin, C-peptide, and insulin secretion rates were significantly higher in subjects with subclinical diabetes than in the other two groups. Proinsulin concentrations were significantly greater in the two diabetic groups than in control subjects, but, when expressed as a percentage of the total insulin immunoreactivity, the differences were significant only in the group with overt diabetes. Weight loss because of hypocaloric feeding resulted in a significant increase in the rate of clearance of endogenously secreted insulin but did not affect the clearance of C-peptide. In obese subjects and those with subclinical diabetes, weight loss was associated with a reduction in insulin secretion rates, presumably as a result of improvements in insulin sensitivity. In patients with overt diabetes and hyperglycemia, weight loss improved beta-cell responsiveness to glucose and was associated with an increase in insulin clearance and a reduction in proinsulin immunoreactivity.(ABSTRACT TRUNCATED AT 250 WORDS)
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In small groups of diabetic patients, insulin clearance has been reported to be normal, decreased, or even increased.
“In small groups of diabetic patients, insulin clearance has reported to be normal, 16 -18 decreased, 19,20 or even increased.21”
From Increased liver fat, impaired insulin clearance, and hepatic and adipose tissue insulin resistance in type 2 diabetes. (2008) · cites this paper as [16]
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- Authors
- Polonsky, K. S., Gumbiner, B., Ostrega, D., Griver, K., Tager, H., & Henry, R. R.
- Affiliations
- University of Rochester Medicine (US)
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 1994-07-01
- Volume
- 43
- Issue
- 7
- Pages
- 871-877
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2152998449
- Cited by
- 56
- References
- 0
- Citations by year
- 2024: 2 · 2023: 1 · 2022: 1 · 2020: 1 · 2019: 2 · 2017: 1 · 2015: 2 · 2014: 1 · 2013: 3 · 2012: 4
- FWCI
- 3.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p30dk026678-20)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-31842, DK 20595, DK-26678)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, weight loss, caloric restriction, proinsulin, insulin clearance, C-peptide, insulin secretion rate, beta-cell function, insulin sensitivity, obesity, subclinical diabetes, hypocaloric diet, refeeding
- MeSH terms
- Blood Glucose, C-Peptide, Circadian Rhythm, Diabetes Mellitus, Diabetes Mellitus, Type 2, Diet, Diabetic, Diet, Reducing, Humans, Insulin, Metabolic Clearance Rate, Middle Aged, Obesity, Proinsulin, Reference Values, Weight Loss
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