Serum and Urine Insulin in Late Pregnancy and in a Few Pregnant Latent Diabetics

Trayner, I.; Welborn, T.; Rubenstein, A. H.; Fraser, T. Russell

doi:10.1677/joe.0.0370443

Cited by 23 publications

(8 citation statements)

References 19 publications

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“…The urine insulin excretion of pregnant women in their third trimester was only slightly elevated above that of non pregnant subjects. However, because the serum insulin levels in the pregnant women were considerably higher than controls, their urinary clearance was correspondingly decreased [133], In rats, G a g l ia r d in o [47] has shown a diurnal rhythm in the excretion of insulin, and comparable data in fasting obese subjects has also been noted [79,117].…”

Section: Excretionmentioning

confidence: 97%

Insulin and the Kidney

Rubenstein

Mako

Horwitz

1975

Nephron

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Changes in renal function and structure are frequently observed in patients with diabetes mellitus. In the early phases of the disease, alterations in glomerular filtration rate, renal plasma flow, glomerular permeability and tubular capacity for glucose reabsorption occur. In the late stages of juvenile onset diabetes, renal failure is a common cause of death. For this reason, increasing attention is being paid to the possibility of long-term dialysis and renal transplantation in these patients. The kidneys play an important role in regulating insulin metabolism. The renal arteriovenous difference is approximately 30–45% and a linear relationship exists between the arterial insulin level and the renal arteriovenous concentration difference. The renal extraction of insulin is 200 ml/min in man, and it is estimated that 6–8 U are removed and degraded by the kidney in 24 h. The quantity of insulin in urine is small. However, its clearance is relatively constant over a wide range of serum concentrations and is 0.15–0.5 ml/min. The mean basal insulin excretion is 3.6 µU/mg creatinine, and a fourfold rise occurs following a glucose load. The urinary insulin values in neonates, children and patients with diabetes and renal failure are reviewed. In diabetic patients, progressive renal disease is accompanied by decreasing insulin requirements. In contrast, nondiabetic patients who develop renal failure frequently show abnormalities in carbohydrate metabolism, the commonest of which is a pseudodiabetic state.

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Section: Excretionmentioning

confidence: 97%

Insulin and the Kidney

Rubenstein

Mako

Horwitz

1975

Nephron

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“…Plasma and serum insulin levels have been measured in human beings (Spellaey & Goetz, 1963;Campbell et al 1971;Trayner et al 1967) and they suggest that high levels of circulating insulin exist in pregnancy. There has been much speculation as to why greatly increased insulin production is necessary in pregnancy, and why it does not result in hypoglycaemia.…”

Section: Islet Sizementioning

confidence: 99%

“…There have been numerous reports (Spellaey & Goetz, 1963;Kalkhoff, Schalch, Leslie Walker, Beck, Kipnis & Daughaday, 1964; Trayner, Welborn, Rubenstein «fe Russel-Fraser, 1967;Campbell, Pyke & Taylor, 1971) which indicate that insulin secretion is increased in pregnant women, although blood sugar levels may be un¬ changed or only marginally lowered. Such studies suggest that there is an increased demand for insulin in human pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Effects of Pregnancy in the Rat on the Size and Insulin Secretory Response of the Islets of Langerhans

Green¹,

Taylor²

1972

Journal of Endocrinology

160

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The secretory response of rat islets of Langerhans was examined during pregnancy and compared with insulin release in normal rat islets. The threshold for a secretory response to glucose was lowered for islets from pregnant rats by comparison with non-pregnant controls. In addition, such islets showed a greatly increased sensitivity to glucose concentrations over the range 3\m=.\5-20 mmol/1. Significantly lower fasting blood glucose levels were found in pregnant rats in vivo, compared with controls.Insulin secretagogues other than glucose were tested for their effects on islets during pregnancy. Despite the high baseline of insulin secretion in response to glucose in pregnancy, there was an additional increased secretory response to arginine and theophylline. In contrast to their response to glucose, pregnant rat islets did not display an increased sensitivity to leucine. Glucagon, while it increased the insulin response of normal islets, had no significant effect on increasing the insulin response from pregnant rat islets suggesting that adenyl cyclase activity is already highly stimulated in pregnancy.In addition, the insulin, DNA and protein content of islets during pregnancy were increased significantly above normal values.The results suggested that rat islets are not only larger in pregnancy, but that they possess a more sensitive mechanism for detecting and responding to glucose and other secretagogues.

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“…However, the underlying reason for increased incidence of morbidity and mortality has not been fully defined. A possible contributing factor is the presence of insulin, in addition to glucose, in urine [8]- [14]. Depending on an individual's disease status, excess insulin is excreted in the urine in both the presence and absence of glucose.…”

Section: Introductionmentioning

confidence: 99%

“…Depending on an individual's disease status, excess insulin is excreted in the urine in both the presence and absence of glucose. Insulin excretion can occur when there is dysregulation of insulin production in response to increased blood glucose levels, peripheral insulin resistance, or, as in the case of insulin-dependent diabetes mellitus, excess insulin levels at the pharmacokinetic peak immediately post-injection [8]- [14]. Although glucose has been shown to be associated with increased bacterial growth and biofilm formation, the role urinary insulin plays in catheter-associated infections has not been explored.…”

Section: Introductionmentioning

confidence: 99%

Effect of Human Insulin on the Formation of Catheter-Associated <i>E. coli</i> Biofilms

Plotkin¹,

Wu²,

Ward³

et al. 2014

OJU

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Biofilm formation is essential for the survival and growth of Escherichia coli in catheter-associated infections. Individuals with type 2 diabetes mellitus can excrete insulin and/or glucose in their urine. This population also has an increased incidence of urinary tract infections. The focus of this study was to determine if the composition of Foley catheter material affects biofilm formation by E. coli in a model system for type 2 diabetes mellitus. Rubber (lubricious-coated), silicon-coated, silver-coated and nitrofurazone-coated catheter segments (5 mm; n = 6) were tested. Catheter segments were added to E. coli ATCC25922 (10 4 CFU/ml, final concentration) in artificial urine alone, or with insulin (40 µU/ml) and/or glucose (0.1%). After incubation (18 h, 37˚C, in air and anaerobically) the level of catheter-associated biofilm was determined by crystal violet staining (Abs 550nm ). Statistical analysis was done by ANOVA with post-hoc analysis (Tukey). Neither nitrofurazone-coated nor silver-coated catheters supported the formation of E. coli biofilm, regardless of growth condition tested. In contrast, under aerobic biofilm formation on silicon catheters was significantly higher (p < 0.05) than that on sterile catheter alone. In addition, glucose with insulin induced significantly more biofilm (p < 0.05) than E. coli controls. Biofilm formation was also significantly increased (p < 0.05) under anaerobic conditions on lubricious-coated rubber catheters as compared to sterile catheters. These results may aid in the development of a catheter material that can prevent biofilm formation, or alternatively guide choice of catheter material for individuals shedding insulin in their urine.

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Serum and Urine Insulin in Late Pregnancy and in a Few Pregnant Latent Diabetics

Cited by 23 publications

References 19 publications

Insulin and the Kidney

Insulin and the Kidney

Effects of Pregnancy in the Rat on the Size and Insulin Secretory Response of the Islets of Langerhans

Effect of Human Insulin on the Formation of Catheter-Associated <i>E. coli</i> Biofilms

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Serum and Urine Insulin in Late Pregnancy and in a Few Pregnant Latent Diabetics

Cited by 23 publications

References 19 publications

Insulin and the Kidney

Insulin and the Kidney

Effects of Pregnancy in the Rat on the Size and Insulin Secretory Response of the Islets of Langerhans

Effect of Human Insulin on the Formation of Catheter-Associated &lt;i&gt;E. coli&lt;/i&gt; Biofilms

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Effect of Human Insulin on the Formation of Catheter-Associated <i>E. coli</i> Biofilms