KINETICS OF INSULIN DISAPPEARANCE FROM PLASMA IN CORTISONE‐TREATED NORMAL SUBJECTS

The effect of glucocorticoid excess on insulin disappearance from plasma was examined in eight normal men during cortisone treatment (50 mg orally twice daily for 4 d) and in the absence of any medication (control) in random order. Constant infusion of insulin (1–5 mU/kg/min) was used to achieve different levels of steady state plasma insulin concentrations; normoglycaemia was preserved by a glucose clamp technique. The experimentally determined data were compared using a previously validated model of saturation kinetics. The amount of glucose required to maintain normoglycaemia during the insulin infusions was significantly less in the cortisone study than in the control study, while the parameter estimates for the kinetics of insulin disappearance from plasma were unaffected by cortisone. Thus, insulin action and insulin kinetics in the steady state are dissociated in normal subjects rendered insulin resistant by short‐term cortisone treatment.

[1]  M. Cassader,et al.  An in vivo and in vitro study of the mechanism of prednisone-induced insulin resistance in healthy subjects. , 1983, The Journal of clinical investigation.

[2]  R. Eaton,et al.  Insulin removal in man: in vivo evidence for a receptor-mediated process. , 1984, The Journal of clinical endocrinology and metabolism.

[3]  M. Muggeo,et al.  Effects of chronic glucocorticoid excess in man on insulin binding to circulating cells: differences between endogenous and exogenous hypercorticism. , 1983, The Journal of clinical endocrinology and metabolism.

[4]  I. Mirsky THE METABOLISM OF INSULIN. , 1964, Diabetes.

[5]  Mirsky Ia THE METABOLISM OF INSULIN. , 1964 .

[6]  C. Kahn Insulin resistance, insulin insensitivity, and insulin unresponsiveness: a necessary distinction. , 1978, Metabolism: clinical and experimental.

[7]  W. Duckworth,et al.  Accelerated Insulin Degradation: An Alternate Mechanism for Insulin Resistance , 1979, Diabetes Care.

[8]  N. Barzilai,et al.  Correlation between insulin clearance and insulin responsiveness: studies in normal, obese, hyperthyroid, and Cushing's syndrome patients. , 1986, Metabolism: clinical and experimental.

[9]  A. Kitabchi,et al.  Hypercortisolism and insulin resistance: comparative effects of prednisone, hydrocortisone, and dexamethasone on insulin binding of human erythrocytes. , 1982, The Journal of clinical endocrinology and metabolism.

[10]  B. Feldt-Rasmussen,et al.  Kinetic models for plasma disappearance of insulin in normal subjects. , 2009, Acta pharmacologica et toxicologica.

[11]  L. Mandarino,et al.  Cortisol-induced insulin resistance in man: impaired suppression of glucose production and stimulation of glucose utilization due to a postreceptor detect of insulin action. , 1982, The Journal of clinical endocrinology and metabolism.

[12]  H. Kuzuya,et al.  Characterization of Seven C-peptide Antisera , 1978, Diabetes.

[13]  K. Minaker,et al.  Impaired in Vivo Insulin Clearance in Patients With Severe Target-Cell Resistance to Insulin , 1982, Diabetes.

[14]  A. Tiengo,et al.  Insulin resistance in Cushing's syndrome. , 1983, The Journal of clinical endocrinology and metabolism.

[15]  S. Juul,et al.  Evidence for a direct effect of bacitracin on cell-mediated insulin degradation in isolated hepatocytes. , 1982, The Biochemical journal.

[16]  D. Steiner,et al.  Binding and degradation of 125I-insulin by rat hepatocytes. , 1975, The Journal of biological chemistry.

[17]  B. Feldt-Rasmussen,et al.  Kinetic models for insulin disappearance from plasma in type I diabetic patients. , 1987, Pharmacology & toxicology.