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Characterization of insulin resistance in type I diabetes

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Summary

Insulin sensitivity was assessed using the euglycaemic clamp technique in eight type I diabetic patients (after overnight blood glucose normalization with an artificial pancreas) and in six healthy subjects. Basal insulin concentrations were higher in diabetic patients (25±4 µU/ml) than in control subjects (17±1 µU/ml;P<0.05). Insulin infusion of 0.5, 1.0, 2.0 and 5.0 mU/kg per min during subsequent 2-h periods resulted in similar mean steady-state insulin concentrations in both groups. The mean dextrose requirements during the last 40 min of each period were nevertheless decreased in diabetic patients (1.6±0.5, 3.5±0.8, 6.5±0.7, 10.2±0.7 mg/kg per min) as compared with control subjects (4.7±0.3, 8.2±0.9, 10.2±0.9, 12.4±0.9 mg/kg per min). At low insulin concentrations dextrose requirements were diminished in all diabetic subjects. At the highest insulin levels, individual dose-response curves from only four patients were within the normal range. Under basal conditions, the monocyte receptor number was significantly reduced in diabetic patients (17,500±2,800 sites/cell) as compared with control subjects (26,700±2,500 sites/cell;P<0.05), whereas there were no differences regarding empty site affinities. Receptor data did not differ in patients with normal and decreased maximal dextrose requirements.

Insulin resistance is apparently a common feature of type I diabetes at serum insulin concentrations of approximately 100 µU/ml. Normalization of the insulin effect by higher insulin concentrations is not possible in all patients. Insulin antibodies at concentrations observed in this study (<0.16 mU/ml) do not contribute significantly to insulin resistance; receptor and postreceptor defects are possibly more important.

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Abbreviations

GCIIS:

Glucose-controlled insulin infusion system

SSGIR:

Steady-state glucose infusion rate

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Authors and Affiliations

  1. Abteilung für Innere Medizin I, Universität Ulm, Germany

    W. Kerner, I. Navascués, T. von Schrenck, P. Arias & E. F. Pfeiffer

  2. Abteilung für Innere Medizin II, Universität Ulm, Germany

    R. Fußgänger

Authors
  1. W. Kerner
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  2. I. Navascués
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  3. T. von Schrenck
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  4. R. Fußgänger
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  5. P. Arias
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  6. E. F. Pfeiffer
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Additional information

I.N. and P.A. were fellows of the Deutscher Akademischer Austauschdienst 1981/82 and 1983/84

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Kerner, W., Navascués, I., von Schrenck, T. et al. Characterization of insulin resistance in type I diabetes. Klin Wochenschr 63, 545–553 (1985). https://doi.org/10.1007/BF01733199

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  • DOI: https://doi.org/10.1007/BF01733199

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