Impaired Insulin-Mediated Skeletal Muscle Blood Flow in Patients With NIDDM

• DOI: 10.2337/diab.41.9.1076
• Publication Date: 2013-09-19T17:22:06Z
• Authors: Markku Laakso; Steven V Edelman; Ginger Brechtel; Alain D Baron
• Keywords: Basal (medicine); Glucose clamp technique

Patients with non-insulin-dependent diabetes metlitus (NIDDM) exhibit decreased rates of skeletal muscle insulin-mediated glucose uptake (IMGU). Because IMGU is equal to the product arteriovenous difference (AVGΔ) across and blood flow (F) into (IMGU = AVGΔ × F), reduced tissue permeability and/or insulin delivery can potentially lead IMGU. The components were studied in six obese NIDDM subjects (103 ± 9 kg) compared those previously determined lean (weight 68 3 kg), (94 normal tolerance. dose-response curves for whole body leg constructed using combined euglycemic clamp balance techniques during sequential infusions (range serum 130–80,000 pmol/L). In lean, obese, subjects, IMGU, femoral AVGΔ, increased a dose-dependent fashion over range an ED50 400–500 pmol/L 1000–1200 4000–7000 (P < 0.01 vs. NIDDM). maximally effective concentrations ∼2-fold from basal 266 957 pmol/L, respectively obese). contrast, F did not increase value (2.7 0.1 3.5 0.5 dl/min, NS). physiological had lower F, than but at concentrations, AVGA differ between subjects. Thus, 1) both are found 2) impaired augmentation patients due diabetic state per se obesity status. Whether result or cause resistance remains be elucidated.