Insulin augmentation of glucose-stimulated insulin secretion is impaired in insulin-resistant humans

Diabetes. 2012 Feb;61(2):301-9. doi: 10.2337/db11-1067.

Abstract

Type 2 diabetes (T2D) is characterized by insulin resistance and pancreatic β-cell dysfunction, the latter possibly caused by a defect in insulin signaling in β-cells. We hypothesized that insulin's effect to potentiate glucose-stimulated insulin secretion (GSIS) would be diminished in insulin-resistant persons. To evaluate the effect of insulin to modulate GSIS in insulin-resistant compared with insulin-sensitive subjects, 10 participants with impaired glucose tolerance (IGT), 11 with T2D, and 8 healthy control subjects were studied on two occasions. The insulin secretory response was assessed by the administration of dextrose for 80 min following a 4-h clamp with either saline infusion (sham) or an isoglycemic-hyperinsulinemic clamp using B28-Asp-insulin (which can be distinguished immunologically from endogenous insulin) that raised insulin concentrations to high physiologic concentrations. Pre-exposure to insulin augmented GSIS in healthy persons. This effect was attenuated in insulin-resistant cohorts, both those with IGT and those with T2D. Insulin potentiates glucose-stimulated insulin secretion in insulin-resistant subjects to a lesser degree than in normal subjects. This is consistent with an effect of insulin to regulate β-cell function in humans in vivo with therapeutic implications.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • C-Peptide / analysis
  • Calcium / metabolism
  • Diabetes Mellitus, Type 2 / metabolism*
  • Female
  • Glucose / pharmacology
  • Humans
  • Insulin / metabolism
  • Insulin / pharmacology*
  • Insulin Resistance*
  • Insulin Secretion
  • Insulin-Secreting Cells / physiology
  • Male
  • Middle Aged

Substances

  • Blood Glucose
  • C-Peptide
  • Insulin
  • Glucose
  • Calcium