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Amendment history:
  • Errata (December 1968)

Research Article Free access | 10.1172/JCI105884

Insulin delivery rate into plasma in normal and diabetic subjects

Michael P. Stern, John W. Farquhar, Abraham Silvers, and Gerald M. Reaven

Department of Medicine, Stanford University School of Medicine, Palo Alto, California 94304

Find articles by Stern, M. in: PubMed | Google Scholar

Department of Medicine, Stanford University School of Medicine, Palo Alto, California 94304

Find articles by Farquhar, J. in: PubMed | Google Scholar

Department of Medicine, Stanford University School of Medicine, Palo Alto, California 94304

Find articles by Silvers, A. in: PubMed | Google Scholar

Department of Medicine, Stanford University School of Medicine, Palo Alto, California 94304

Find articles by Reaven, G. in: PubMed | Google Scholar

Published September 1, 1968 - More info

Published in Volume 47, Issue 9 on September 1, 1968
J Clin Invest. 1968;47(9):1947–1957. https://doi.org/10.1172/JCI105884.
© 1968 The American Society for Clinical Investigation
Published September 1, 1968 - Version history
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Abstract

Removal of insulin-131I from plasma was studied in normal and diabetic subjects with both single injection and continuous infusion of isotope techniques. Patients were studied either in the fasting state or during steady-state hyperglycemia produced by a continuous intravenous glucose infusion. Steady-state plasma insulin concentration during these studies ranged from 10 to 264 μU/ml. Labeled insulin specific activity time curves consisted of more than one exponential, indicating that a multicompartmental system for insulin metabolism exists. A mathematical technique which is applicable to non-first order processes was used to calculate the rate at which insulin was lost irreversibly from the plasma insulin pool. A direct, linear relationship was found between insulin irreversible loss rate and plasma insulin concentration over the range of concentrations studied. This linearity implies lack of saturability of the insulin removal mechanism. Since the plasma insulin pool was in a steady state during these studies, insulin irreversible loss rate was equal to the rate at which newly secreted insulin was being delivered to the general circulation. Therefore, these results indicate that changes in plasma insulin concentration result from parallel changes in the rate of insulin delivery and not from changes in the opposite direction of the rate of insulin removal. A wide range of insulin delivery rates was found among patients with similar plasma glucose concentrations, suggesting that there exists considerable variability in responsiveness to endogenous insulin among these patients.

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