Insulin sensitivity and vascular disease in insulin-dependent diabetics.

Martin, F. I. R.; Stocks, A.E.

doi:10.1136/bmj.2.5597.81

Cited by 44 publications

(28 citation statements)

References 13 publications

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“…A significant association between the presence of clinical vascular disease and a reduced hypoglycaemic effect of intravenous insulin has been reported previously in a group of longterm insulin-dependent diabetics (Martin and Stocks, 1968). We report here a similar association in maturity-onset nonketotic diabetics not receiving insulin.…”

Section: Introductionsupporting

confidence: 89%

Insulin sensitivity and vascular disease in maturity-onset diabetics

Martin¹

1969

BMJ

Self Cite

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Section: Introductionsupporting

confidence: 89%

Insulin sensitivity and vascular disease in maturity-onset diabetics

Martin¹

1969

BMJ

Self Cite

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“…For example, severely insulin-deficient, ketosis prone, animals and man have been shown to be insulin resistant (27)(28)(29) …”

Section: Discussionmentioning

confidence: 99%

Long-Term Regulation of Adipocyte Glucose Transport Capacity by Circulating Insulin in Rats

Kobayashi¹,

Olefsky²

1978

J. Clin. Invest.

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A B S T R A C T We have tested the idea that the circulating plasma insulin level plays an important role in the long-term regulation, or maintenance, of the cellular glucose transport system, distinct from insulin's ability to acutely accelerate glucose transport. To study this hypothesis, groups of rats were made either hyperinsulinemic or hypoinsulinemic by daily insulin injections, or streptozotocin treatment, respectively. Different levels of hypoinsulinemia were produced by using different doses of streptozotocin (40 and 55 mg/kg). The mean (+SE) 9 a.m. plasma insulin level for each experimental group was: hyperinsulinemic animals, 65+5 ,uU/ml; controls, 32+3 AU/ml; low dose streptozotocin group, 18+3 ,uU/ml; and high dose streptozotocin group 5+2 ,uU/ml. Isolated adipocytes were prepared from each animal and glucose transport was assessed by measuring the initial rates of uptake of the nonmetabolyzable hexose 2-deoxy glucose. The Vmax and Km values for adipocyte glucose transport were calculated from the 2-deoxy glucose uptake data. The hypoinsulinemic rats. Furthermore, when the individual data were analyzed, highly significant correlation coefficients were found between the height ofthe plasma insulin level and both the basal (r = 0.82, P < 0.001) and insulin-stimulated (r = 0.93, P < 0.001) Vmax values. The apparent Km for 2-deoxy glucose uptake was the same under all conditions.In conclusion, assuming that the Vmax of transport is some function of the number of glucose transport carriers per cell, then these results support the hypothesis that in addition to acute acceleration of glucose transport, insulin is also an important long-term regulator of the number of available adipocyte glucose transport carriers.

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“…In addition, ϳ33% of patients without nephropathy or with good glycemic control met the diagnostic criteria. Given the strong association between metabolic syndrome and vascular complications in patients with diabetes (1,4,(22)(23)(24), these statistics are a matter of concern. The overall prevalence of the metabolic syndrome in FinnDiane patients (39%) was approximately three times that seen in nondiabetic subjects in the Finnish population but lower than that observed in patients with type 2 diabetes (78 -84%) (1,2).…”

Section: Effect Of Renal Function and Insulin Sensitivitymentioning

confidence: 99%

“…Certainly, in both type 1 and type 2 diabetes, the role of insulin resistance seems to be equally important as a cardiovascular risk factor (22)(23)(24)26). Insulin resistance has also been implicated in the pathogenesis of diabetic nephropathy (17).…”

Section: Effect Of Renal Function and Insulin Sensitivitymentioning

confidence: 99%

Metabolic Syndrome in Type 1 Diabetes

et al. 2005

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OBJECTIVE -The aim of this study was to estimate the prevalence of the metabolic syndrome in Finnish type 1 diabetic patients and to assess whether it is associated with diabetic nephropathy or poor glycemic control.RESEARCH DESIGN AND METHODS -In all, 2,415 type 1 diabetic patients (51% men, mean age 37 years, duration of diabetes 22 years) participating in the nationwide, multicenter Finnish Diabetic Nephropathy (FinnDiane) study were included. Metabolic syndrome was defined according to the National Cholesterol Education Program diagnostic criteria. Patients were classified as having normal albumin excretion rate (AER) (n ϭ 1,261), microalbuminuria (n ϭ 326), macroalbuminuria (n ϭ 383), or end-stage renal disease (ESRD) (n ϭ 164). Glycemic control was classified as good (HbA 1c Ͻ7.5%), intermediate (7.5-9.0%), or poor (Ͼ9.0%). Creatinine clearance was estimated with the Cockcroft-Gault formula.RESULTS -The overall prevalence of metabolic syndrome was 38% in men and 40% in women. The prevalence was 28% in those with normal AER, 44% in microalbuminuric patients, 62% in macroalbuminuric patients, and 68% in patients with ESRD (P Ͻ 0.001). Patients with metabolic syndrome had a 3.75-fold odds ratio for diabetic nephropathy (95% CI 2.89 -4.85), and all of the separate components of the syndrome were independently associated with diabetic nephropathy. The prevalence of metabolic syndrome was 31% in patients with good glycemic control, 36% in patients with intermediate glycemic control, and 51% in patients with poor glycemic control (P Ͻ 0.001). Similarly, metabolic syndrome increased with worsening creatinine clearance.CONCLUSIONS -The metabolic syndrome is a frequent finding in type 1 diabetes and increases with advanced diabetic nephropathy and worse glycemic control.

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Insulin sensitivity and vascular disease in insulin-dependent diabetics.

Cited by 44 publications

References 13 publications

Insulin sensitivity and vascular disease in maturity-onset diabetics

Insulin sensitivity and vascular disease in maturity-onset diabetics

Long-Term Regulation of Adipocyte Glucose Transport Capacity by Circulating Insulin in Rats

Metabolic Syndrome in Type 1 Diabetes

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