Potentiation of insulin secretory responses by plasma glucose levels in man: evidence that hyperglycemia in diabetes compensates for imparied glucose potentiation.

ABSTRACT Insulin secretory responses to nonglucose stimuli may be of normal magnitude in maturity-onset diabetics (MOD). We have used the β-adrenergic agent isoproterenol as a tool to assess the role of basal hyperglycemia in maintaining these islet responses of MOD. The acute insulin responses (AIR; mean Δ 2- to 4-min immunoreactive insulin) to 12 μg isoproterenol increased in eight MOD and eight controls when plasma glucose (PG) levels were increasedby glucose infusions. Although increases of PG were similar in the two groups, differences ofAIR of controls vs. those of MOD were magnified during glucose infusion: AIR, 40 ± 8vs. 20 ± 15 μU/ml,(mean ± SEM), P < 0.05, baseline; and 263 ± 56 vs. 60 ± 20, P < 0.01, 900 mg/min glucose infusion. Conversely, infusion of insulin for 2 h lowered PG and inhibited the AIR to isoproterenol in six controls (Δglucose, -11 ± 2 mg/dl; AAIR, -15 ± 3μU/ml, P < 0.01 vs. baseline AIR) and six MOD (Δglucose, -112 ± 21; ΔAIR, -11 ± 4, P < 0.05). For each subject, the potentiat...

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