Aspects of glucose homeostasis in uremia as assessed by the hyperinsulinemic euglycemic clamp technique.
A three-step hyperinsulinemic euglycemic clamp was performed in 14 nondialyzed uremic and ten age-matched healthy subjects. Nine of the uremics were restudied for a mean of 42 days (range, 21 to 88 days) after initiation of dialysis therapy. Insulin was infused at the following three rates: 0.5 mU X kg-1 X min-1, 2.0 mU X kg-1 X min-1, and 4.0 mU X kg-1 X min-1. Each dose was given for 120 minutes. Glucose uptake during the last 30 minutes of each clamp were consistently lower in uremic patients pre-dialysis than in controls (2.3 +/- 0.3 v 6.6 +/- 0.8 mg X kg-1 X min, 7.8 +/- 0.6 v 13.2 +/- 1.1 mg X kg-1 X min-1 and 9.6 +/- 0.7 v 15.5 +/- 1.0 mg X kg-1 X min-1, all P less than 0.001). Serum insulin levels were similar in the two groups, and blood glucose values during steady state were maintained at 79 +/- 2.77 +/- 2, and 77 +/- 2 mg/100 mL in uremic subjects and at 72 +/- 3, 73 +/- 2, and 75 +/- 2 mg/100 mL in healthy subjects. The insulin levels required to elicit half-maximal biological response in uremics (82 +/- 5 microU/mL) were markedly higher than in controls (54 +/- 8 microU/mL, P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002395:Catecholamines / Q000097:blood; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005934:Glucagon / Q000097:blood; D005947:Glucose / Q000378:metabolism*; D013006:Growth Hormone / Q000097:blood; D006706:Homeostasis; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D066298:In Vitro Techniques; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism; D006435:Renal Dialysis; D014511:Uremia / Q000378:metabolism* / Q000628:therapy
D001786:Blood Glucose; D002395:Catecholamines; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D013006:Growth Hormone; D005934:Glucagon; D005947:Glucose; D006854:Hydrocortisone