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. 1967 Oct;46(10):1549–1557. doi: 10.1172/JCI105646

The Significance of Basal Insulin Levels in the Evaluation of the Insulin Response to Glucose in Diabetic and Nondiabetic Subjects*

John D Bagdade 1,, Edwin L Bierman 1,§, Daniel Porte Jr 1,ǁ
PMCID: PMC292903  PMID: 6061732

Abstract

The level of insulin after an overnight fast (basal) in 37 obese and nonobese male subjects with normal and abnormal carbohydrate tolerance was directly related to the increase in insulin concentration during a 3 hr 100 g oral glucose tolerance test. Obesity, but not diabetes, was associated with an elevation of this basal insulin level. Thus obesity predicted with the magnitude of the insulin response to glucose ingestion. When the individual insulin values were expressed as per cent change from the basal level, this effect of obesity was excluded. The insulin levels of all subjects with normal carbohydrate tolerance promptly rose 5-7-fold, and reached peak values 1 hr after oral glucose. In contrast, the diabetic response (as per cent increase) was markedly reduced during the 1st hr, and maximal (but still subnormal) insulin levels were not attained until 2 hr. In all subjects the insulin response (quantitated by calculation of the area circumscribed by a plot of the per cent change in insulin with time) showed a significant inverse correlation with the glucose response. Thus increasing degrees of carbohydrate intolerance were associated with decreasing insulin responses. Elevated levels of insulin, in both the basal state and in response to glucose, were related to obesity.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BURNS T. W., BREGANT R., VANPEENAN H. J., HOOD T. E. EVALUATION OF THE ORAL GLUCOSE TOLERANCE TEST BY A CONTINUOUS SAMPLING TECHNIQUE. J Lab Clin Med. 1965 Jun;65:927–943. [PubMed] [Google Scholar]
  2. Berson S. A., Yalow R. S. Some current controversies in diabetes research. Diabetes. 1965 Sep;14(9):549–572. doi: 10.2337/diab.14.9.549. [DOI] [PubMed] [Google Scholar]
  3. CERASI E., LUFT R. PLASMA-INSULIN RESPONSE TO SUSTAINED HYPERGLYCEMIA INDUCED BY GLUCOSE INFUSION IN HUMAN SUBJECTS. Lancet. 1963 Dec 28;2(7322):1359–1361. doi: 10.1016/s0140-6736(63)90740-2. [DOI] [PubMed] [Google Scholar]
  4. HUGGETT A. S., NIXON D. A. Use of glucose oxidase, peroxidase, and O-dianisidine in determination of blood and urinary glucose. Lancet. 1957 Aug 24;273(6991):368–370. doi: 10.1016/s0140-6736(57)92595-3. [DOI] [PubMed] [Google Scholar]
  5. KARAM J. H., GRODSKY G. M., FORSHAM P. H. Excessive insulin response to glucose in obese subjects as measured by immunochemical assay. Diabetes. 1963 May-Jun;12:197–204. doi: 10.2337/diab.12.3.197. [DOI] [PubMed] [Google Scholar]
  6. KARAM J. H., GRODSKY G. M., PAVLATOS F. C., FORSHAM P. H. CRITICAL FACTORS IN EXCESSIVE SERUM-INSULIN RESPONSE TO GLUCOSE. OBESITY IN MATURITY-ONSET DIABETES AND GROWTH HORMONE IN ACROMEGALY. Lancet. 1965 Feb 6;1(7380):286–289. doi: 10.1016/s0140-6736(65)91026-3. [DOI] [PubMed] [Google Scholar]
  7. Karam J. H., Grodsky G. M., Forsham P. H. The relationship of obesity and growth hormone to serum insulin levels. Ann N Y Acad Sci. 1965 Oct 8;131(1):374–387. doi: 10.1111/j.1749-6632.1965.tb34804.x. [DOI] [PubMed] [Google Scholar]
  8. Kreisberg R. A., Boshell B. R., DiPlacido J., Roddam R. F. Insulin secretion in obesity. N Engl J Med. 1967 Feb 9;276(6):314–319. doi: 10.1056/NEJM196702092760603. [DOI] [PubMed] [Google Scholar]
  9. Perley M., Kipnis D. M. Plasma insulin responses to glucose and tolbutamide of normal weight and obese diabetic and nondiabetic subjects. Diabetes. 1966 Dec;15(12):867–874. doi: 10.2337/diab.15.12.867. [DOI] [PubMed] [Google Scholar]
  10. RABINOWITZ D., ZIERLER K. L. Forearm metabolism in obesity and its response to intra-arterial insulin. Characterization of insulin resistance and evidence for adaptive hyperinsulinism. J Clin Invest. 1962 Dec;41:2173–2181. doi: 10.1172/JCI104676. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Seltzer H. S., Allen E. W., Herron A. L., Jr, Brennan M. T. Insulin secretion in response to glycemic stimulus: relation of delayed initial release to carbohydrate intolerance in mild diabetes mellitus. J Clin Invest. 1967 Mar;46(3):323–335. doi: 10.1172/JCI105534. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Sheldon J., Taylor K. W., Anderson J. The effects of long-term acetohexamide treatment on pancreatic islet cell function in maturity-onset diabetes. Metabolism. 1966 Oct;15(10):874–883. doi: 10.1016/0026-0495(66)90158-2. [DOI] [PubMed] [Google Scholar]
  13. Simpson R. G., Benedetti A., Grodsky G. M., Karam J. H., Forsham P. H. Stimulation of insulin release by glucagon in noninsulin-dependent diabetics. Metabolism. 1966 Nov;15(11):1046–1049. doi: 10.1016/0026-0495(66)90055-2. [DOI] [PubMed] [Google Scholar]
  14. YALOW R. S., BERSON S. A. Immunoassay of endogenous plasma insulin in man. J Clin Invest. 1960 Jul;39:1157–1175. doi: 10.1172/JCI104130. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Yalow R. S., Glick S. M., Roth J., Berson S. A. Plasma insulin and growth hormone levels in obesity and diabetes. Ann N Y Acad Sci. 1965 Oct 8;131(1):357–373. doi: 10.1111/j.1749-6632.1965.tb34803.x. [DOI] [PubMed] [Google Scholar]

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