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1 Cellular & Molecular Physiology, Penn State College of Medicine, Hershey, Pennsylvania, United States; Internal Medicine, Hallym University College of Medicine, Seoul, Korea, Republic of
2 Cellular & Molecular Physiology, Penn State College of Medicine, Hershey, Pennsylvania, United States
3 Cellular and Molecular Physiology, Penn State College of Medicine, Hershey, Pennsylvania, United States; Internal Medicine, Penn State College of Medicine, Hershey, Pennsylvania, United States
4 Hershey, Pennsylvania, United States; Internal Medicine, Penn State College of Medicine, Hershey, Pennsylvania, United States
5 Cellular & Molecular Physiology, Penn State College of Medicine, Hershey, Pennsylvania, United States; Internal Medicine, Penn State College of Medicine, Hershey, Pennsylvania, United States
* To whom correspondence should be addressed. E-mail: jason.kim{at}psu.edu.
Although insulin resistance has been traditionally associated with type 2 diabetes, recent evidence in humans and animal models indicate that insulin resistance may also develop in type 1 diabetes. A point mutation of insulin 2 gene in Ins2Akita mice leads to pancreatic
-cell apoptosis and hyperglycemia, and these mice are commonly used to investigate type 1 diabetes and complications. Since insulin resistance plays an important role in diabetic complications, we performed hyperinsulinemic-euglycemic clamps in awake Ins2Akita mice and wild-type mice to measure insulin action and glucose metabolism in vivo. Nonobese Ins2Akita mice developed insulin resistance, as indicated by ~80% reduction in glucose infusion rate during clamps. Insulin resistance was due to ~50% decreases in glucose uptake in skeletal muscle and brown adipose tissue as well as hepatic insulin action. Skeletal muscle insulin resistance was associated with a 40% reduction in total GLUT4 and a 3-fold increase in PKC-
levels in Ins2Akita mice. Chronic phloridzin treatment lowered systemic glucose levels and normalized muscle insulin action, GLUT4 and PKC-
levels in Ins2Akita mice, indicating that hyperglycemia plays a role in insulin resistance. Echocardiography showed significant cardiac remodeling with ventricular hypertrophy that was ameliorated following chronic phloridzin treatment in Ins2Akita mice. Overall, we report for the first time that nonobese, insulin-deficient Ins2Akita mice develop type 2 diabetes phenotypes including peripheral and hepatic insulin resistance and cardiac remodeling. Our findings provide important insights into the pathogenesis of metabolic abnormalities and complications affecting type 1 diabetes and lean type 2 diabetes subjects.
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