P oor control of postprandial glycemia in type 2 diabetes is associated with elevated rates of all-cause mortality (1), making postprandial hyperglycemia an attractive pharmaceutical target. Individuals who have type 2 diabetes and receive monoamine oxidase inhibitors demonstrate more frequent episodes of hypoglycemia (2), and those who take selective serotonin reuptake inhibitors have improved glucose tolerance (3) compared with similar individuals who do not take these drugs. Moreover, intraperitoneal administration of serotonin (5-hydroxytryptamine [5-HT]) or its precursor 5-hydroxytryptophan has a hypoglycemic effect in mice (4). 5-HT accumulated in both the liver and the brain of the mice, leaving a question of which tissue was responsible for the hypoglycemia. However, in subsequent studies, the mice were also treated with carbidopa, an inhibitor of peripheral but not central aromatic amino acid decarboxylase. Neither hypoglycemia nor hepatic accumulation of 5-HT was observed in carbidopa-treated mice, although brain levels of 5-HT were even higher than in the absence of carbidopa. Thus, it seemed that hypoglycemia was related to the elevation of hepatic 5-HT (5). We hypothesized that 5-HT can reduce postprandial glycemia by enhancing NHGU and examined this hypothesis in conscious dogs in which the pancreatic hormones and hepatic glucose load (HGL) could be fixed.
RESEARCH DESIGN AND METHODSAnimals and surgical procedures. Studies were carried out on 16 conscious 42-h-fasted mongrel dogs of either sex with a mean weight of 24 Ϯ 1 kg. Diet and housing were as previously described (6), and the protocol was approved by the Vanderbilt University Medical Center Animal Care Committee.Approximately 16 days before study, each dog underwent a laparotomy for placement of ultrasonic flow probes around the portal vein and the hepatic artery, as well as for insertion of silicone rubber catheters for sampling in a hepatic vein, the portal vein, and a femoral artery and for infusion into a splenic and a jejunal vein as described in detail elsewhere (6,7). Criteria for study were as previously described (6,7).On the morning of the study, catheters and flow probe leads were exteriorized from their subcutaneous pockets (6,7). The splenic and jejunal catheters were used for intraportal infusion of insulin (Eli Lilly & Co., Indianapolis, IN), glucagon (GlucaGen; Bedford Laboratories, Bedford, OH), and 5-HT (5-HT creatinine sulfate complex; Sigma, St. Louis, MO). Angiocaths (Deseret Medical, Sandy, UT) were inserted into three peripheral veins. Experimental design. Each experiment consisted of a 90-min equilibration period (Ϫ120 to Ϫ30 min), a 30-min basal period (Ϫ30 to 0 min), and a 270-min experimental period (0 to 270 min) divided into four subperiods (P1, 0 -90 min; P2, 90 -150 min; P3, 150 -210 min, and P4, 210 -270 min). At Ϫ120 min, a primed, continuous infusion of [3-3 H]glucose and a continuous infusion of indocyanine green dye (5 g ⅐ kg Ϫ1 ⅐ min Ϫ1 ) were begun in all dogs, with the exception of two that did not re...