Sodium-lithium countertransport activity and insulin resistance in normotensive IDDM patients

Faria, José B. Lopes de; Jones, Susan Y.; Macdonald, F. R.; Chambers, John; Mattock, M. B.; Gc, Viberti

doi:10.2337/diabetes.41.5.610

Cited by 26 publications

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“…Insulin resistance has also been described in association with microalbuminuria in normotensive Type 1 diabetic patients. These patients were further characterized by increased sodium-lithium countertransport activity [28,29]. An inverse relationship was also found between sodiumlithium countertransport activity and insulin-mediated glucose disposal [29].…”

Section: Discussionmentioning

confidence: 92%

Insulin resistance, hypertension and microalbuminuria in patients with Type 2 (non-insulin-dependent) diabetes mellitus

et al. 1993

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Summary.We examined the impact of hypertension and microalbuminuria on insulin sensitivity in patients with Type 2 (non-insttlin-dependent) diabetes mellitus using the euglycaemic insulin clamp technique in 52 Type 2 diabetic patients and in 19 healthy control subjects. Twenty-five diabetic patients had hypertension and 19 had microalbuminuria. Hypertension per se was associated with a 27 % reduction in the rate of total glucose metabolism and a 40 % reduction in the rate of non-oxidative glucose metabolism compared with normotensive Type 2 diabetic patients (both p < 0.001). Glucose metabolism was also impaired in normotensive microalbuminuric patients compared with normotensive normoalbuminuric patients (29.4 + 2.2 vs 40.5 + 2.8 gmol. kg lean body mass -1. min-t; p = 0.012), primarily due to a reduction in non-oxidative glucose metabolism (12.7+2.9 vs 21.1+2.6btmol.kg lean body mass 1. min-1;p = 0.06). In a factorial ANOVA design, however, only hypertension (p = 0.008) and the combination of hypertension and microalbuminuria (p = 0.030) were significantly associated with the rate of glucose metabolism. The highest triglyceride and lowest HDL cholesterol concentrations were observed in Type 2 diabetic patients with both hypertension and microalbuminuria. Of note, glucose metabolism was indistinguishable from that in control subjects in Type 2 diabetic patients without hypertension and microalbuminuria (40.5 + 2.8 vs 44.4_+ 2.8 gmol. kg lean body mass -1. rain 1). We conclude that insulin resistance in Type 2 diabetes is predominantly associated with either hypertension or microalbuminuria or with both.

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Section: Discussionmentioning

confidence: 92%