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The hyperinsulinaemic-euglycaemic glucose clamp: Reproducibility and metbolic effects of prolonged insulin infusion in healthy subjects
Department of Surgery, Karolinska Hospital, Stockholm, Sweden; N. Western Injury Research Centre, Hope Hospital, Salford, Manchester, United Kingdom.
Department of Surgery, Karolinska Hospital, Stockholm, Sweden; Karolinska Inst. at Ersta Hospital, Centre of Gastrointestinal Disease, Stockholm, Sweden.
Department of Endocrinology, Karolinska Hospital, Stockholm, Sweden.
Department of Surgery, Karolinska Inst. at Huddinge U., Huddinge, Sweden; Karolinska Inst. at Ersta Hospital, Centre of Gastrointestinal Disease, Stockholm, Sweden.
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2000 (English)In: Clinical Science, ISSN 0143-5221, E-ISSN 1470-8736, Vol. 98, no 4, 367-374 p.Article in journal (Refereed) Published
Abstract [en]

To examine the reproducibility of the hyperinsulinaemic-euglycaemic clamp technique at mid-physiological hyperinsulinaemia, seven healthy subjects {age 50 (25, 59) years [median (range)], body mass index 23.1 (20.8, 25.5) kg·m-2}were investigated with three 2 h hyperinsulinaemic (60 μmol·l-1)-euglycaemic (4.5 mmol·l-1) clamps performed 48 h and 14 days apart respectively. The third clamp was prolonged to 8 h in order to examine effects on glucose disposal during prolonged clamps. The glucose infusion rates (GIRs) during the three 2 h clamps were 7.41 (4.28, 10.96), 7.26 (5.38, 11.02) and 6.63 (4.42, 10.3) mg·kg-1·min-1, with a median intra-individual coefficient of variation of 5.8 (2.6, 22) %. During the 8 h clamp a highly variable gradual increase in GIR was observed, reaching a plateau between 4 and 5 h at 32 (5, 101) % above the GIR between 1 and 2 h (P < 0.05). This increase was correlated inversely with the GIR between 1 and 2 h (r = -0.82; P < 0.05), and directly with age (r = 0.86; P < 0.05). Carbohydrate oxidation measured by indirect calorimetry was stable during the repeated 2 h clamps and the 8 h clamp. Endogenous glucose production measured by infusion of [6,6-2H2]glucose was suppressed during the 8 h clamp. The 2 h hyperinsulinaemic-euglycaemic clamp is reproducible at a mid-physiological range of hyperinsulinaemia. If prolonged, it results in a delayed increase in nonoxidative glucose disposal, which is most pronounced in subjects with low insulin sensitivity. The findings underline the importance of selecting age-matched controls in studies of insulin resistance.

Place, publisher, year, edition, pages
Portland Press, 2000. Vol. 98, no 4, 367-374 p.
Keyword [en]
Glucose clamp technique, Glucose metabolism, Glucose tracers, Reproducibility
National Category
Medical and Health Sciences Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:oru:diva-64015DOI: 10.1042/cs0980367ISI: 000086631700002PubMedID: 10731469Scopus ID: 2-s2.0-0034072924OAI: oai:DiVA.org:oru-64015DiVA: diva2:1172724
Available from: 2018-01-10 Created: 2018-01-10 Last updated: 2018-01-19Bibliographically approved

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Ljungqvist, Olle

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