Insulin clearance from plasma in type I (insulin-dependent) diabetic patients: influence of glycaemic level.
The influence of the actual glycaemic level on the kinetics of insulin disappearance from plasma was studied in 16 type I diabetic patients. Constant intravenous infusion of insulin (1-5 mU.kg-1.min.-1) was used to achieve different levels of steady state plasma free insulin concentrations, while the blood glucose level was clamped at normoglycaemia, 4.1 +/- 0.1 mmol/l (mean +/- S.E.M.), and mild hyperglycaemia, 8.2 +/- 0.1 mmol/l. The experimentally determined data were compared using a previously validated model of first order kinetics for insulin disappearance from plasma in diabetic patients. At the physiological insulin concentration range the median clearance rate of insulin was 23 ml.kg-1.min-1 (range 16-26) at normoglycaemia and 23 ml.kg-1.min-1 (19-35) at hyperglycaemia (P = 0.45). At supraphysiological levels, insulin was cleared at a lower rate at normoglycaemia than at hyperglycaemia. No correlation was observed between the insulin clearance rate and the duration of diabetes or the haemoglobin A1C level (both Spearman's rho = 0.08). In conclusion, the insulin clearance rate from plasma is independent of the actual glycaemic level and hardly influenced by the long-term glycaemic level in type I diabetic patients.
Thorsteinsson
B
B
Steno Memorial Hospital, Gentofte, Denmark.
Fugleberg
S
S
Binder
C
C
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000493:pharmacokinetics*; D008657:Metabolic Clearance Rate; D008875:Middle Aged
D001786:Blood Glucose; D007328:Insulin