Effect of subcutaneous insulin detemir on glucose flux, lipolysis and electroencephalography in type 1 diabetes.
The aim of the present study was to investigate the effects of subcutaneous detemir on glucose flux, lipid metabolism and brain function. Twelve people with type 1 diabetes received, in random order, 0.5 units/kg body weight detemir or NPH insulin. Glucose concentration was clamped at 5 mmol/l then increased to 10 mmol/l. Glucose production rate (glucose Ra), glucose uptake (glucose Rd) and glycerol production (glycerol Ra) were measured with a constant intravenous infusion of [6,6(2) H(2)]glucose and [(2)H(5)]glycerol. Electroencephalography direct current (DC) and alternating current (AC) potentials were measured. While detemir induced similar effects on glucose Ra, glucose Rd and glycerol Ra during euglycaemia compared with NPH, it triggered a distinct negative shift in DC potentials, with a significant treatment effect in frontal cerebrocortical channels (p < 0.001). AC spectral power showed significant differences in theta and alpha frequencies during euglycaemia (p = 0.03). Subcutaneous detemir exerts different effects on brain function when compared with NPH in people with type 1 diabetes. This may be an important mechanism behind the limitation of weight gain with detemir.
Centre for Endocrinology, Diabetes and Research, Royal Surrey County Hospital, Guildford, UK.
R
R
Herring
Surrey Clinical Research Centre, University of Surrey, Guildford, UK.
R
R
Knight
Diabetes and Metabolic Medicine, University of Surrey, Guildford, UK.
F
F
Shojaee-Moradie
Surrey Clinical Research Centre, University of Surrey, Guildford, UK.
S
S
Johnsen
Diabetes and Metabolic Medicine, University of Surrey, Guildford, UK.
A M
AM
Umpleby
Diabetes and Metabolic Medicine, University of Surrey, Guildford, UK.
N
N
Jackson
Diabetes and Metabolic Medicine, University of Surrey, Guildford, UK.
R
R
Jones
Surrey Clinical Research Centre, University of Surrey, Guildford, UK.|Surrey Sleep Research Centre, University of Surrey, Guildford, UK.
D-J
DJ
Dijk
Centre for Endocrinology, Diabetes and Research, Royal Surrey County Hospital, Guildford, UK.|Diabetes and Metabolic Medicine, University of Surrey, Guildford, UK.
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DL
Russell-Jones
D000328:Adult; D001786:Blood Glucose / Q000187:drug effects*; D001921:Brain / Q000187:drug effects; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D004569:Electroencephalography / Q000187:drug effects*; D005260:Female; D005990:Glycerol / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D000069057:Insulin Detemir / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D007336:Insulin, Isophane / Q000008:administration & dosage; D008066:Lipolysis / Q000187:drug effects*; D008297:Male; D015430:Weight Gain / Q000187:drug effects
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D000069057:Insulin Detemir; D007336:Insulin, Isophane; D005990:Glycerol
glucose metabolism; insulin detemir; lipid metabolism; type 1 diabetes; weight