Abstract
Insulin resistance is characteristic of the diabetic state. To define the role of hyperglycemia in generation of the insulin resistance, we examined the effect of phlorizin treatment on tissue sensitivity to insulin in partially pancreatectomized rats. Five groups were studied: group I, sham-operated controls; group II, partially pancreatectomized diabetic rats with moderate glucose intolerance; group III, diabetic rats treated with phlorizin to normalize glucose tolerance; group IV, phlorizin-treated controls; and group V, phlorizin-treated diabetic rats restudied after discontinuation of phlorizin. Insulin sensitivity was assessed with the euglyemic hyperinsulinemic clamp technique in awake, unstressed rats. Insulin-mediated glucose metabolism was reduced by approximately 30% (P less than 0.001) in diabetic rats. Phlorizin treatment of diabetic rats completely normalized insulin sensitivity but had no effect on insulin action in controls. Discontinuation of phlorizin in phlorizin-treated diabetic rats resulted in the reemergence of insulin resistance. These data demonstrate that a reduction of beta-cell mass leads to the development of insulin resistance, and correction of hyperglycemia with phlorizin, without change in insulin levels, normalizes insulin sensitivity. These results provide the first in vivo evidence that hyperglycemia per se can lead to the development of insulin resistance.
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- Beck-Nielsen H., Richelsen B., Hasling C., Nielsen O. H., Heding L., Sørensen N. S. Improved in vivo insulin effect during continuous subcutaneous insulin infusion in patients with IDDM. Diabetes. 1984 Sep;33(9):832–837. doi: 10.2337/diab.33.9.832. [DOI] [PubMed] [Google Scholar]
- Bevilacqua S., Barrett E. J., Smith D., Simonson D. C., Olsson M., Bratusch-Marrain P., Ferrannini E., DeFronzo R. A. Hepatic and peripheral insulin resistance following streptozotocin-induced insulin deficiency in the dog. Metabolism. 1985 Sep;34(9):817–825. doi: 10.1016/0026-0495(85)90105-2. [DOI] [PubMed] [Google Scholar]
- Björntorp P., Berchtold P., Holm J., Larsson B. The glucose uptake of human adipose tissue in obesity. Eur J Clin Invest. 1971 Sep;1(6):480–485. doi: 10.1111/j.1365-2362.1971.tb00559.x. [DOI] [PubMed] [Google Scholar]
- Björntorp P., Krotkiewski M., Larsson B., Somlo-Szücs Z. Effects of feeding states on lipid radioactivity in liver, muscle and adipose tissue after injection of labelled glucose in the rat. Acta Physiol Scand. 1970 Sep;80(1):29–38. doi: 10.1111/j.1748-1716.1970.tb04766.x. [DOI] [PubMed] [Google Scholar]
- Bonner-Weir S., Trent D. F., Weir G. C. Partial pancreatectomy in the rat and subsequent defect in glucose-induced insulin release. J Clin Invest. 1983 Jun;71(6):1544–1553. doi: 10.1172/JCI110910. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dall'Aglio E., Chang H., Hollenbeck C. B., Mondon C. E., Sims C., Reaven G. M. In vivo and in vitro resistance to maximal insulin-stimulated glucose disposal in insulin deficiency. Am J Physiol. 1985 Sep;249(3 Pt 1):E312–E316. doi: 10.1152/ajpendo.1985.249.3.E312. [DOI] [PubMed] [Google Scholar]
- DeFronzo R. A., Ferrannini E., Hendler R., Felig P., Wahren J. Regulation of splanchnic and peripheral glucose uptake by insulin and hyperglycemia in man. Diabetes. 1983 Jan;32(1):35–45. doi: 10.2337/diab.32.1.35. [DOI] [PubMed] [Google Scholar]
- DeFronzo R. A., Ferrannini E., Koivisto V. New concepts in the pathogenesis and treatment of noninsulin-dependent diabetes mellitus. Am J Med. 1983 Jan 17;74(1A):52–81. doi: 10.1016/0002-9343(83)90654-x. [DOI] [PubMed] [Google Scholar]
- DeFronzo R. A., Gunnarsson R., Björkman O., Olsson M., Wahren J. Effects of insulin on peripheral and splanchnic glucose metabolism in noninsulin-dependent (type II) diabetes mellitus. J Clin Invest. 1985 Jul;76(1):149–155. doi: 10.1172/JCI111938. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DeFronzo R. A., Hendler R., Simonson D. Insulin resistance is a prominent feature of insulin-dependent diabetes. Diabetes. 1982 Sep;31(9):795–801. doi: 10.2337/diab.31.9.795. [DOI] [PubMed] [Google Scholar]
- DeFronzo R. A., Jacot E., Jequier E., Maeder E., Wahren J., Felber J. P. The effect of insulin on the disposal of intravenous glucose. Results from indirect calorimetry and hepatic and femoral venous catheterization. Diabetes. 1981 Dec;30(12):1000–1007. doi: 10.2337/diab.30.12.1000. [DOI] [PubMed] [Google Scholar]
- DeFronzo R. A., Tobin J. D., Andres R. Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol. 1979 Sep;237(3):E214–E223. doi: 10.1152/ajpendo.1979.237.3.E214. [DOI] [PubMed] [Google Scholar]
- DeFronzo R., Deibert D., Hendler R., Felig P., Soman V. Insulin sensitivity and insulin binding to monocytes in maturity-onset diabetes. J Clin Invest. 1979 May;63(5):939–946. doi: 10.1172/JCI109394. [DOI] [PMC free article] [PubMed] [Google Scholar] [Retracted]
- Efendić S., Wajngot A., Cerasi E., Luft R. Insulin release, insulin sensitivity, and glucose intolerance. Proc Natl Acad Sci U S A. 1980 Dec;77(12):7425–7429. doi: 10.1073/pnas.77.12.7425. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Garvey W. T., Olefsky J. M., Griffin J., Hamman R. F., Kolterman O. G. The effect of insulin treatment on insulin secretion and insulin action in type II diabetes mellitus. Diabetes. 1985 Mar;34(3):222–234. doi: 10.2337/diab.34.3.222. [DOI] [PubMed] [Google Scholar]
- Grill V., Rundfeldt M. Abnormalities of insulin responses after ambient and previous exposure to glucose in streptozocin-diabetic and dexamethasone-treated rats. Role of hyperglycemia and increased B-cell demands. Diabetes. 1986 Jan;35(1):44–51. doi: 10.2337/diab.35.1.44. [DOI] [PubMed] [Google Scholar]
- Hollenbeck C. B., Chen Y. D., Reaven G. M. A comparison of the relative effects of obesity and non-insulin-dependent diabetes mellitus on in vivo insulin-stimulated glucose utilization. Diabetes. 1984 Jul;33(7):622–626. doi: 10.2337/diab.33.7.622. [DOI] [PubMed] [Google Scholar]
- Kolterman O. G., Gray R. S., Griffin J., Burstein P., Insel J., Scarlett J. A., Olefsky J. M. Receptor and postreceptor defects contribute to the insulin resistance in noninsulin-dependent diabetes mellitus. J Clin Invest. 1981 Oct;68(4):957–969. doi: 10.1172/JCI110350. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lager I., Lönnroth P., von Schenck H., Smith U. Reversal of insulin resistance in type I diabetes after treatment with continuous subcutaneous insulin infusion. Br Med J (Clin Res Ed) 1983 Dec 3;287(6406):1661–1664. doi: 10.1136/bmj.287.6406.1661. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Le Marchand-Brustel Y., Freychet P. Effect of fasting and streptozotocin diabetes on insulin binding and action in the isolated mouse soleus muscle. J Clin Invest. 1979 Nov;64(5):1505–1515. doi: 10.1172/JCI109609. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Leahy J. L., Weir G. C. Unresponsiveness to glucose in a streptozocin model of diabetes. Inappropriate insulin and glucagon responses to a reduction of glucose concentration. Diabetes. 1985 Jul;34(7):653–659. doi: 10.2337/diab.34.7.653. [DOI] [PubMed] [Google Scholar]
- Levy J., Gavin J. R., 3rd, Fausto A., Gingerich R. L., Avioli L. V. Impaired insulin action in rats with non-insulin-dependent diabetes. Diabetes. 1984 Sep;33(9):901–906. doi: 10.2337/diab.33.9.901. [DOI] [PubMed] [Google Scholar]
- Lorenzi M., Cagliero E., Toledo S. Glucose toxicity for human endothelial cells in culture. Delayed replication, disturbed cell cycle, and accelerated death. Diabetes. 1985 Jul;34(7):621–627. doi: 10.2337/diab.34.7.621. [DOI] [PubMed] [Google Scholar]
- Pupo A. A., Ursich M. J., Iamaguchi E., Vasconcellos F. G. Department of Medicina, Faculdade de Medicina da Universidade de São Paulo, Brazil. Diabetes. 1976 Mar;25(3):161–166. [PubMed] [Google Scholar]
- Reaven G. M., Sageman W. S., Swenson R. S. Development of insulin resistance in normal dogs following alloxan-induced insulin deficiency. Diabetologia. 1977 Sep;13(5):459–462. doi: 10.1007/BF01234496. [DOI] [PubMed] [Google Scholar]
- Revers R. R., Kolterman O. G., Scarlett J. A., Gray R. S., Olefsky J. M. Lack of in vivo insulin resistance in controlled insulin-dependent, type I, diabetic patients. J Clin Endocrinol Metab. 1984 Feb;58(2):353–358. doi: 10.1210/jcem-58-2-353. [DOI] [PubMed] [Google Scholar]
- Rossetti L., Klein-Robbenhaar G., Giebisch G., Smith D., DeFronzo R. Effect of insulin on renal potassium metabolism. Am J Physiol. 1987 Jan;252(1 Pt 2):F60–F64. doi: 10.1152/ajprenal.1987.252.1.F60. [DOI] [PubMed] [Google Scholar]
- Scarlett J. A., Gray R. S., Griffin J., Olefsky J. M., Kolterman O. G. Insulin treatment reverses the insulin resistance of type II diabetes mellitus. Diabetes Care. 1982 Jul-Aug;5(4):353–363. doi: 10.2337/diacare.5.4.353. [DOI] [PubMed] [Google Scholar]
- Simonson D. C., Tamborlane W. V., Sherwin R. S., Smith J. D., DeFronzo R. A. Improved insulin sensitivity in patients with type I diabetes mellitus after CSII. Diabetes. 1985 Aug;34 (Suppl 3):80–86. doi: 10.2337/diab.34.3.s80. [DOI] [PubMed] [Google Scholar]
- Starke A., Grundy S., McGarry J. D., Unger R. H. Correction of hyperglycemia with phloridzin restores the glucagon response to glucose in insulin-deficient dogs: implications for human diabetes. Proc Natl Acad Sci U S A. 1985 Mar;82(5):1544–1546. doi: 10.1073/pnas.82.5.1544. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Unger R. H., Grundy S. Hyperglycaemia as an inducer as well as a consequence of impaired islet cell function and insulin resistance: implications for the management of diabetes. Diabetologia. 1985 Mar;28(3):119–121. doi: 10.1007/BF00273856. [DOI] [PubMed] [Google Scholar]
- Ward W. K., Bolgiano D. C., McKnight B., Halter J. B., Porte D., Jr Diminished B cell secretory capacity in patients with noninsulin-dependent diabetes mellitus. J Clin Invest. 1984 Oct;74(4):1318–1328. doi: 10.1172/JCI111542. [DOI] [PMC free article] [PubMed] [Google Scholar]