The majority of insulin-like growth factor I (IGF-I) circulates in blood bound to a family of IGF-binding proteins (IGFBPs). Only a small fraction of IGF-I is unbound or free, and one of the postulated roles of the IGFBPs is regulation of this free component, thereby increasing IGF-I bioavailability. Whether free IGF-I plays a physiological role in glucose homeostasis, however, is not clear. In this study, we examined the effects of acute changes in serum insulin on free IGF-I, total IGF-I, IGFBP-1, and IGFBP-3 in 11 healthy subjects. Glucose (0.3 g/kg) and insulin (0.05 U/kg) were injected iv at 0 and 20 min, respectively. Blood samples were drawn at defined intervals for 3 h, and insulin sensitivity (S I ) was computed by Bergman's minimal model. Serum insulin reached a first peak after glucose injection and a second, higher peak after exogenous insulin administration. Although the total IGF-I level remained constant for the duration of the experiment, free IGF-I decreased by 20% 20 min after the first insulin peak and by 35% 20 min after the second peak. IGFBP-1 first declined to 20% below basal, then rose to 3-fold the basal level. IGFBP-3 increased linearly to 20% above basal by the end of the experiment, and this increase mirrored the decline of free IGF-I. In the fasting state, free IGF-I was positively correlated with S I (r ϭ 0.52; P Ͻ 0.005) and inversely correlated with glucose (r ϭ Ϫ0.51; P Ͻ 0.005) and IGFBP-1 (r ϭ Ϫ0.65; P Ͻ 0.001). In conclusion, free IGF-I is acutely regulated by insulin and correlates with S I , suggesting that it may play a physiological role in glucose homeostasis. (J Clin Endocrinol Metab 82: [2177][2178][2179][2180][2181] 1997) T HE REGULATION of blood glucose is a complex phenomenon that involves insulin-mediated glucose disposal by muscle, fat, and liver (the classic target tissues for insulin) and noninsulin-dependent glucose utilization by the brain and splanchnic tissues (1). The effects of insulin are opposed by multiple counterregulatory hormones. Insulinlike growth factor I (IGF-I) and IGF-II are structurally similar to proinsulin and functionally similar to insulin (2). Administration of recombinant human IGF-I has been shown to induce hypoglycemia even in the absence of endogenous insulin (3). Most IGFs circulate in blood bound to a family of IGF-binding proteins (IGFBPs), six of which have been cloned and sequenced (4). These IGFBPs have been shown to be released by several cell types and may either augment or inhibit the actions of the IGFs. IGFBP-1 and IGFBP-3 are the best characterized of the six circulating IGFBPs. IGFBP-3 is classically considered to be a reservoir transporting IGFs in the blood stream in a 150-kDa complex that also includes the liver-derived acid-labile subunit.Recently, IGFBP-3 has been shown to undergo partial proteolysis under certain conditions, and this is believed to increase circulating free IGFs and promote IGF bioavailability (5). However, IGFBP-1 is the sole binding protein that has been unequivocally demonstrated to mod...