Hyperglycemia is a persistent symptom in diabetes mellitus. The complex pathogenesis of type 2 diabetes, its most common form, involves the progressive development of insulin resistance and defective insulin secretion, which leads to overt hyperglycemia.1) Genetic and environmental factors such as extraordinary nutritional conditions contribute to the development of insulin resistance and a defect in insulin secretion.2) However, the molecular basis for development of insulin resistance has not been documented. Patients with type 2 diabetes have elevated blood levels of glucagon, cortisol, fatty acids, protein, glucose and possibly acute phase reactants. Provonsha et al., have suggested the possibility that this can occur with meals, resulting a multilevel, multiorgan interference with glucose handling, and can also be caused by the release of the endogenous substance during starvation.
3)There are many studies concerning the effects of refeeding on plasma glucose and insulin levels. [4][5][6][7] Insulin is thought to play a major role in the physiological adaptation of tissues to fasting and refeeding. Insulin secretion diminishes during starvation and increases upon refeeding. 8,9) Insulin-stimulated glucose uptake in adipose tissue was decreased by fasting and its overshoot was caused by refeeding. 10) Penicaud et al., have used euglycemic-hyperinsulinemic clamps on rats to show that insulin resistance is induced by 3-d fasting and is restored by 3-d refeeding.11) Insulin resistance was induced by fasting and it contributes to the glucose intolerance in human.12) However the ability to stimulate glucose metabolism in rat skeletal muscle was enhanced by fasting.13) It seems that influences of fasting to insulin sensitivity depends on the tissues.The aim of our study is to examine whether defects in insulin secretion and in insulin action are induced by fasting and/or refeeding. In the present study, we found that the sustained hyperglycemia induced by refeeding mice standard chow pellets after the 48 h fasting was caused by defective insulin secretion in the early phase, and by the resulting insulin resistance in the late phase.
MATERIALS AND METHODSAnimal Care Six week-old male ddY mice were purchased from Japan SLC Inc. (Hamamatsu). The mice were maintained on 12 h light/dark cycles for two weeks with free access to the standard chow pellets (MF diet, Oriental Yeast Co., Ltd.) and water. Mice weighing 36-38 g were then used.Experimental Design Fasting was started by removing the chow pellets from their home cages at 9:00 p.m. After 24 or 48 h, the mice were refed standard chow pellets, blood was obtained at the indicated time for glucose and insulin assays. Control mice were fed the standard chow pellets ad libitum. Glucose levels were determined by using the assay kit, Glucose-B Test Wako (Wako Pure Chemical Industries, Ltd., Osaka, Japan) on serum separated by centrifuging blood obtained from the caudal vein. The insulin level was determined using the Insulin Assay Kit (Seikagaku Corporation, Tokyo) on ser...