November 1, 2001The Journal of Clinical Endocrinology & Metabolism
Evidence for Spatial Heterogeneity in Insulin- and Exercise-Induced Increases in Glucose Uptake: Studies in Normal Subjects and Patients with Type 1 Diabetes
Why the study?
Is there spatial heterogeneity in insulin- and exercise-induced increases in glucose uptake in patients with type 1 diabetes compared to normal subjects?
Population
15 subjects: 8 patients with type 1 diabetes and 7 age- and weight-matched normal subjects.
Comparison
Euglycemic hyperinsulinemia and one-legged… vs Age- and weight-matched normal subjects.
Design
Cross-sectional
Authors
Discussion
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Member takes
Implication
Greater heterogeneity of glucose uptake in T1D is associated with lower total uptake; hypothesis-generating and requires prospective validation before clinical relevance.
Key Points
- This research aims to determine if glucose uptake in skeletal muscle varies spatially in response to insulin and exercise in type 1 diabetic patients compared to normal subjects.
- Compared muscle glucose uptake and blood flow in eight type 1 diabetic patients and seven normal subjects using positron emission tomography, involving euglycemic hyperinsulinemia and one-legged exercise.
- Evaluated heterogeneity by calculating relative dispersion of glucose uptake and blood flow in femoral muscle during rest and exercise.
- Insulin-stimulated glucose uptake was significantly lower in type 1 diabetic patients (42 +/- 7 micromol/kg per min) compared to normal subjects (78 +/- 9 micromol/kg per min, P < 0.001).
- Type 1 diabetic patients displayed greater heterogeneity in glucose uptake at rest (RD(g) 31 +/- 1%) and during exercise (RD(g) 27 +/- 1%) compared to normal subjects (P < 0.05).
- Heterogeneity of glucose uptake was inversely related to total glucose uptake (r = -0.54, P < 0.001), indicating that more insulin-resistant individuals have higher variability in glucose uptake.
Structured PICO
Is there spatial heterogeneity in insulin- and exercise-induced increases in glucose uptake in patients with type 1 diabetes compared to normal subjects?
P
Population
15 subjects: 8 patients with type 1 diabetes (age 24 +/- 1 yr, body mass index 22.0 +/- 0.8 kg/m2) and 7 age- and weight-matched normal subjects.
I
Intervention
Euglycemic hyperinsulinemia and one-legged exercise evaluated using positron emission tomography, [18F]-fluoro-deoxy-glucose, and [15O]-water.
C
Comparator
Age- and weight-matched normal subjects.
O
Outcome
Distributions and heterogeneity (relative dispersion) of muscle glucose uptake and blood flow.surrogate
Glucose uptake in human skeletal muscle is a spatially heterogeneous process, and this heterogeneity is increased in insulin-resistant patients with type 1 diabetes.
Cite This Study
Peltoniemi et al. (2001) studied this question.