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Effects of pulsatile delivery of insulin and glucagon in humans.
Paolisso, G.; Scheen, André; Albert, Adelin et al.
1989In American Journal of Physiology, 257 (5 Pt 1), p. 686-96
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Keywords :
Adult; Blood Glucose/analysis; Glucagon/administration & dosage; Humans; Infusions, Intravenous; Insulin/administration & dosage; Insulin Infusion Systems; Kinetics; Male; Pancreatic Hormones/blood; Pulsatile Flow; Statistics as Topic
Abstract :
[en] The purpose of the present study was to investigate the respective effects of continuous intravenous delivery of both insulin and glucagon compared with those of pulsatile insulin (and continuous glucagon), pulsatile glucagon (and continuous insulin) and both hormones administered in a pulsatile manner (but out of phase) on various parameters of glucose turnover. The study was performed on six healthy male volunteers submitted to a 325-min glucose-controlled glucose intravenous infusion using the Biostator. The endogenous secretion of pancreatic hormones was inhibited by somatostatin (2 micrograms/min). Four combinations of continuous and pulsatile infusions of insulin and glucagon were performed on different days and in random order. The amounts of hormone infused were identical in all instances and were 0.2 mU.kg-1.min-1 (continuous insulin), 67 ng/min (continuous glucagon), 1.3 mU.kg-1.min-1 and 435 ng/min with a switching on-off length of 2-11 min (for intermittent insulin and glucagon delivery, respectively). In the case of pulsatile administration of both hormones, the pulses of insulin and glucagon were given out of phase with a 6-min interval. Blood glucose levels and glucose infusion rate were monitored continuously by the Biostator, and classic methodology using a D-[3-3H]glucose infusion allowed to study glucose turnover. When compared with pulsatile insulin and continuous glucagon, pulsatile glucagon and continuous insulin were characterized by a significantly higher endogenous (hepatic) glucose production. When both insulin and glucagon were delivered in a pulsatile manner, the effect of pulsatile glucagon was predominant, maintaining a high endogenous glucose production. Under no circumstance was an effect on glucose utilization or clearance detected. This study demonstrates that pulsatile delivery of insulin or glucagon in humans has greater effects in modulating endogenous glucose production than continuous infusion. Furthermore, when both insulin and glucagon are delivered intermittently and out of phase, the stimulatory effect of glucagon on endogenous glucose production prevails over the inhibitory effect of insulin.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Paolisso, G.
Scheen, André  ;  Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale
Albert, Adelin  ;  Université de Liège - ULiège > Département des sciences de la santé publique > Informatique médicale et biostatistique - Département de mathématique
Lefebvre, Pierre ;  Centre Hospitalier Universitaire de Liège - CHU > Diabétologie,nutrition, maladies métaboliques
Language :
English
Title :
Effects of pulsatile delivery of insulin and glucagon in humans.
Publication date :
1989
Journal title :
American Journal of Physiology
ISSN :
0002-9513
Publisher :
American Physiological Society, Bethesda, United States - Maryland
Volume :
257
Issue :
5 Pt 1
Pages :
E686-96
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 08 June 2009

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