Glucagon supports postabsorptive plasma glucose concentrations in humans with biologically optimal insulin levels

Benjamin A. Cooperberg, Philip E. Cryer

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

OBJECTIVE - Based on the premise that postabsorptive patients with type 1 diabetes receiving intravenous insulin in a dose that maintains stable euglycemia are receiving biologically optimal insulin replacement, we tested the hypothesis that glucagon supports postabsorptive plasma glucose concentrations in humans. RESEARCH DESIGN AND METHODS - Fourteen patients with type 1 diabetes were studied after an overnight fast on up to five occasions. Insulin was infused intravenously to hold plasma glucose concentrations at ∼100 mg/dl (5.6 mmol/l) overnight and fixed from -60 to 240 min the following morning. From 0 through 180 min the patients also received 1) saline, 2) octreotide 30 ng · kg-1 · min-1 with growth hormone replacement or octreotide with growth hormone, plus 3) glucagon in doses of 0.5 ng · kg-1 · min-1, 4) 1.0 ng · kg-1 · min-1, and 5) 2.0 ng · kg -1 · min-1. RESULTS - Compared with a mean · SE of 98 · 5 mg/dl (5.4 · 0.3 mmol/l) at 180 min during saline, mean plasma glucose concentrations declined to 58 · 1 mg/dl (3.2 · 0.1 mmol/l) (P < 0.001) at 180 min during octreotide plus saline and were 104 · 16 mg/dl (5.8 · 0.9 mmol/l) (NS), 143 · 13 mg/dl (7.9 · 0.7 mmol/l) (P = 0.004), and 160 · 15 mg/dl (8.9 · 0.8 mmol/l) (P < 0.001) at 180 min during octreotide plus glucagon in doses of 0.5, 1.0, and 2.0 ng · kg-1 · min-1, respectively. CONCLUSIONS - In the setting of biologically optimal insulin replacement, suppression of glucagon secretion with octreotide caused a progressive fall in plasma glucose concentrations that was prevented by glucagon replacement. These data document that glucagon supports postabsorptive glucose concentrations in humans.

Original languageEnglish
Pages (from-to)2941-2944
Number of pages4
JournalDiabetes
Volume59
Issue number11
DOIs
StatePublished - Nov 1 2010

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