Insulin action and pharmacokinetics in insulin treated diabetics during the third trimester of pregnancy.
Insulin action and pharmacokinetics were compared, using the euglycaemic insulin clamp technique, in seven insulin-treated diabetics during the third trimester of pregnancy and one to three weeks post-partum. At an insulin infusion rate of 1 mU/kg/min, insulin mediated glucose disposal was significantly greater (p less than 0.02) following delivery (1.194 +/- 0.138 mmol/m2/min) than in pregnancy (0.761 +/- 0.072 mmol/m2/min) and the rate of decline in insulin mediated glucose disposal, at the end of the insulin infusion, was significantly greater (p less than 0.02) following delivery (24.78 +/- 4.22 mumol/m2/min2) than in pregnancy (15.17 +/- 2.00 mumol/m2/min2). The metabolic clearance rate, distribution space and pharmacological half-life of insulin were not significantly altered by pregnancy. These findings show that the third trimester of pregnancy is associated with steady state insulin resistance accompanied by a reduced rate of insulin deactivation, but normal insulin pharmacokinetics.
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D006207:Half-Life; D006801:Humans; D007328:Insulin / Q000097:blood / Q000493:pharmacokinetics* / Q000494:pharmacology; D007333:Insulin Resistance; D007700:Kinetics; D008657:Metabolic Clearance Rate; D049590:Postpartum Period; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011254:Pregnancy in Diabetics / Q000097:blood*
D001786:Blood Glucose; D007328:Insulin