Glucose metabolism and leg blood flow after pancreas/kidney transplantation

Guenther Boden, Richard Desantis, Xinhua Chen, Michael Morris, Francisco Badoza

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Patients with insulin-dependent diabetes mellitus (IDDM) who have undergone combined pancreas and kidney (P/K) transplantation, are hyperinsulinemic and have impaired insulin-stimulated whole body glucose uptake. We have investigated whether their reduced glucose uptake was due to insulin resistance at the tissue level or was caused by reduced muscle blood flow, previously reported to be present in patients with IDDM. Leg blood flow (LBF, determined with mercury strain-gauge plethysmography), glucose uptake (GRd, determined with 6, 6 D2-glucose), and glucose oxidation (Gox, determined by indirect calorimetry) were obtained during euglycemic-hyperinsulinemic (approximately 500 pM) clamping in five P/K patients, five kidney transplant (K) patients, and six controls. Insulin-stimulated GRd was reduced in P/K patients compared to controls (23 ± 4 vs. 44 ± 6 mumol/kg/min, P < 0.05); Gox was comparable but glucose storage was reduced in P/K and K patients compared to controls (9 ± 3 and 13 ± 4 vs. 28 ± 7 mumol/kg/min, P < 0.05). Basal LBF (3.9 ± 0.3, 4.6 ± 0.9, and 4.9 ± 0.6 mL/dL leg tissue/min) and insulin-stimulated LBF (5.6 ± 0.6, 6.1 ± 1.1 and 6.1 ± 0.9 mL/dL leg tissue/min) were similar in P/K, K patients, and controls. We concluded, that P/K patients had normal muscle blood flow but were insulin resistant at the tissue level, and that the insulin resistance was responsible, at least in part, for their hyperinsulinemia.

Original languageEnglish (US)
Pages (from-to)1229-1233
Number of pages5
JournalJournal of Clinical Endocrinology and Metabolism
Volume76
Issue number5
DOIs
StatePublished - May 1993

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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