Interstitial insulin during euglycemic-hyperinsulinemic clamp in obese and lean individuals

Mokshagundam, Sri Prakash L.; Peiris, Alan N.; Stagner, John I.; Gingerich, Ronald L.; Samols, Ellis

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Volume 45, Issue 8 , Pages 951-956, August 1996

Interstitial insulin during euglycemic-hyperinsulinemic clamp in obese and lean individuals

Sri Prakash L. Mokshagundam
- Address reprint requests to Sri Prakash L. Mokshagundam, MD, Division of Diabetes and Endocrinology, University of Louisville and Louisville VA Medical Center, 530 S Jackson St, Louisville, KY 40202.
- Department of Medicine, University of Louisville and Louisville Veterans Administration Medical Center, Louisville, KY, USA
- Department of Medicine, East Tennessee State University, Johnson City, TN, USA
- LINCO Research, St Louis, MO, USA
Alan N. Peiris
- Department of Medicine, University of Louisville and Louisville Veterans Administration Medical Center, Louisville, KY, USA
- Department of Medicine, East Tennessee State University, Johnson City, TN, USA
- LINCO Research, St Louis, MO, USA
John I. Stagner
- Department of Medicine, University of Louisville and Louisville Veterans Administration Medical Center, Louisville, KY, USA
- Department of Medicine, East Tennessee State University, Johnson City, TN, USA
- LINCO Research, St Louis, MO, USA
Ronald L. Gingerich
- Department of Medicine, University of Louisville and Louisville Veterans Administration Medical Center, Louisville, KY, USA
- Department of Medicine, East Tennessee State University, Johnson City, TN, USA
- LINCO Research, St Louis, MO, USA
Ellis Samols
- Department of Medicine, University of Louisville and Louisville Veterans Administration Medical Center, Louisville, KY, USA
- Department of Medicine, East Tennessee State University, Johnson City, TN, USA
- LINCO Research, St Louis, MO, USA

Received 2 August 1995; accepted 14 February 1996.

Abstract

Transcapillary insulin transport has been considered a rate-limiting step of insulin action. However, direct measurement of interstitial insulin levels during physiologic levels of insulinemia have not been performed. We determined changes in interstitial insulin in eight healthy non-obese men and seven healthy obese men by microdialysis during a euglycemichyperinsulinemic clamp. Interstitial insulin was determined in the subcutaneous tissue of the abdomen and thigh. Steady-state insulin concentrations were reached approximately 10 minutes after the start of insulin infusion in the subcutaneous tissue of the abdomen and thigh and returned to basal levels approximately 10 minutes after the infusion was discontinued. There was no difference in the rapidity of change in interstitial insulin between obese and lean individuals at either site studied, irrespective of the pattern of fat distribution. The relative change in dialysate insulin concentration during the euglycemic clamp did not differ between obese and lean individuals at either site studied. It was also unaffected by the waist to hip ratio. The rapid change in interstitial insulin concentration could be of physiologic significance in determining the effects of changes in circulating insulin concentration. We conclude that transcapillary insulin transport in adipose tissue is unaffected by obesity and the pattern of fat distribution in healthy men. It is also concluded that when interstitial insulin is determined directly, transcapillary insulin transport is rapid and does not demonstrate a significant lag phase.

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