Insulin clearance from plasma in type I (insulin-dependent) diabetic patients: influence of glycaemic level
Thorsteinsson, B.; Fugleberg, S.; Binder, C.
Pharmacology and Toxicology 62(4): 206-209
1988
ISSN/ISBN: 0901-9928 PMID: 3290880 Document Number: 322175
The influence of the actual glycemic level on the kinetics of insulin disappearance from plasma was studied in 16 type I diabetic patients. Constant intravenous infusion of insulin (1-5 mU .cntdot. kg-1 .cntdot. min.-1) was used to achieve different levels of steady state plasma free insulin concentrations, while the blood glucose level was clamped at normoglycemia, 4.1 .+-. 0.1 mmol/l (mean .+-. S.E.M), and mild hyperglycemia, 8.2 .+-. 0.1 mmol/l. The experimentally determined data were compared using a previously validated model of first order kinetics for insulin disappearance from plasma in diabetic patients. At the physiological insulin concentration range the median clearance rate of insulin was 23 ml .cntdot. kg-1 .cntdot. min.-1 (range 16-26) at normoglycemia and 23 ml .cntdot. kg-1 .cntdot. min.-1 (19-35) at hyperglycemia (P = 0.45). At supraphysiological levels, insulin was cleared at a lower rate at normoglycemia than at hyperglycemia. No correlation was observed between the insulin clearance rate and the duration of diabetes or the hemoglobin A1C level (both Spearman's rho = 0.08). In conclusion, the insulin clearance rate from plasma is independent of the actual glycemia level and hardly influenced by the long-term glycemic level in type I diabetic patients.