Comparison of insulin action on glucose versus potassium uptake in humans.

Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101271570 Publication Model: Print Cited Medium: Internet ISSN: 1555-905X (Electronic) Linking ISSN: 15559041 NLM ISO Abbreviation: Clin J Am Soc Nephrol Subsets: MEDLINE

Publication: 2023- : Hagerstown, MD : Wolters Kluwer Health
Original Publication: Washington, D.C. : American Society of Nephrology, c2005-

Blood Glucose/*metabolism ; Diabetes Mellitus, Type 2/*blood ; Insulin/*blood ; Potassium/*blood; Adult ; Case-Control Studies ; Chi-Square Distribution ; Creatinine/blood ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/urine ; Female ; Glucose Clamp Technique ; Humans ; Hypoglycemic Agents/therapeutic use ; Lipids/blood ; Male ; Middle Aged ; Phosphorus/blood ; Potassium/urine ; Texas ; Time Factors

Background and Objectives: Insulin has several physiologic actions that include stimulation of cellular glucose and potassium uptake. The ability of insulin to induce glucose uptake by cells is impaired in type 2 diabetes mellitus, but whether potassium uptake is similarly impaired is not known. This study examines whether the cellular uptake of these molecules is regulated in concert or independently.
Design, Setting, Participants, & Measurements: Thirty-two nondiabetic and 13 type 2 diabetic subjects with normal GFR were given a similar, constant metabolic diet for 8 days. On day 9, they were subjected to a hyperinsulinemic euglycemic clamp for 2 hours. Serum and urinary chemistry were obtained before and during the clamp. Glucose disposal rate was calculated from glucose infusion rate during hyperinsulinemic euglycemia. Intracellular potassium and phosphate uptake were calculated by the reduction of extracellular potassium or phosphate content corrected for urinary excretion.
Results: Although glucose disposal rate tended to be lower in type 2 diabetics, cellular potassium uptake was similar between diabetics and nondiabetics. Additionally, although glucose disposal rate was lower with increasing body mass index (R² = 0.362), cellular potassium (R² = 0.052), and phosphate (R² = 0.002), uptake rates did not correlate with body mass index. There was also no correlation between glucose disposal rate and potassium (R² = 0.016) or phosphate uptake (R² = 0.053). Conclusions Insulin-stimulated intracellular uptake of glucose and potassium are independent of each other. In type 2 diabetes, potassium uptake is preserved despite impaired glucose disposal.

Comment in: Clin J Am Soc Nephrol. 2011 Jul;6(7):1513-6. (PMID: 21700825)

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K23 RR021710 United States RR NCRR NIH HHS; M01-RR00633 United States RR NCRR NIH HHS; M01 RR000633 United States RR NCRR NIH HHS; K23-RR21710 United States RR NCRR NIH HHS; R01 DK081423 United States DK NIDDK NIH HHS; P01 DK020543 United States DK NIDDK NIH HHS; P01-DK20543 United States DK NIDDK NIH HHS; R01-DK081423 United States DK NIDDK NIH HHS

0 (Blood Glucose)
0 (Hypoglycemic Agents)
0 (Insulin)
0 (Lipids)
27YLU75U4W (Phosphorus)
AYI8EX34EU (Creatinine)
RWP5GA015D (Potassium)

Date Created: 20110708 Date Completed: 20111108 Latest Revision: 20220317

20240628

PMC3133473

10.2215/CJN.00750111

21734082