Effect of insulin antibodies on insulin pharmacokinetics and glucose utilization in insulin-dependent diabetic patients.
To determine the impact of insulin-binding antibodies on total (TIRI) and free insulin (FIRI) as well as on insulin sensitivity, 10 insulin-dependent diabetic patients (IDDM) with poststimulatory C-peptide less than 100 pmol/L and an insulin binding capacity (IBC) between less than 1 and 294 micrograms/L serum were studied during and after a 1-h nonprimed, constant-rate insulin infusion (study 1: 0.057 U/kg body wt, study 2: 0.286 U/kg body wt). Euglycemia was maintained by variable glucose infusion. Control studies were performed in 5 healthy subjects. Basal TIRI (mU/L) was lowest in healthy subjects (16 +/- 1 [SE]) and elevated in diabetic patients (IBC less than 25 micrograms/L: 72 +/- 11, IBC greater than 25 micrograms/L: 1772 +/- 842), whereas serum concentrations of FIRI were considerably smaller but still two- to threefold greater (P less than 0.01) in the patients than in healthy subjects (13 +/- 1). After intravenous (i.v.) insulin administration, almost identical increments in serum TIRI were seen in healthy subjects and in diabetic patients with low IBC (less than 25 micrograms/L), whereas those with high IBC (greater than 25 micrograms/L) had a heterogeneous response.(ABSTRACT TRUNCATED AT 250 WORDS)
D000293:Adolescent; D000328:Adult; D000368:Aged; D002096:C-Peptide / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000378:metabolism*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006207:Half-Life; D006801:Humans; D007263:Infusions, Parenteral; D007328:Insulin / Q000008:administration & dosage / Q000097:blood / Q000378:metabolism*; D007330:Insulin Antibodies / Q000032:analysis / Q000096:biosynthesis*; D007700:Kinetics; D008297:Male; D008875:Middle Aged
D002096:C-Peptide; D007328:Insulin; D007330:Insulin Antibodies; D005947:Glucose