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Diabetes Division, Department of Medicine, University of Texas Health Science Center, San Antonio, Texas 78284
Decreased insulin-mediated muscle glucose uptake
is a characteristic feature of non-insulin-dependent diabetes mellitus
and other insulin-resistant states. It has been suggested that an impairment in the ability of insulin to augment limb blood flow, resulting in diminished glucose delivery to muscle, may contribute to
this abnormality. In this study, we used human insulin-like growth
factor (IGF) I in conjunction with the forearm balance technique to
determine whether forearm glucose uptake could be stimulated by
increasing blood flow without directly stimulating the intrinsic
ability of the muscle to extract glucose. IGF-I was infused
intra-arterially in healthy controls at a rate of either 0.4 µg · kg
1 · min
1
(high IGF) or 0.04 µg · kg
1 · min
1
(low IGF) for 140 min. With high IGF, forearm blood flow increased approximately twofold (34 ± 3 vs. 64 ± 8 ml · min
1 · l
forearm volume
1,
P < 0.01), and arteriovenous glucose
concentration difference (a-v difference) increased modestly (0.19 ± 0.05 vs. 0.31 ± 0.08 mM,
P = 0.32), resulting in an increased
forearm glucose uptake (6.4 ± 1.7 vs. 21.7 ± 7.4 µmol · min
1 · l
forearm volume
1,
P = 0.09 vs. basal). With low IGF,
forearm blood flow increased by 59% (29 ± 4 vs. 46 ± 9 ml · min
1 · l
forearm volume
1,
P < 0.05) and was associated with a
proportional decrease in the a-v difference (0.29 ± 0.04 vs. 0.18 ± 0.05 mM, P < 0.05). Forearm
glucose uptake therefore was not significantly different from basal
values (7.6 ± 0.6 vs. 6.9 ± 1.8 µmol · min
1 · kg
1).
These data demonstrate that increasing blood flow without increasing the intrinsic ability of the muscle to extract glucose does not increase forearm muscle glucose uptake.
insulin-like growth factor I; insulin resistance
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