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Effect of insulin on renal sodium handling and renal haemodynamics in insulin-dependent (type 1) diabetes mellitus patients

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Abstract

The effects of insulin on renal haemodynamics and renal sodium handling were studied in eight insulindependent (type 1) diabetic patients (aged 30±3 years). Seven healthy men (aged 38±4 years) served as controls. The type 1 diabetic patients were resistant to insulin-stimulated glucose disposal as estimated by a 45% lower metabolic (P<0.01) clearance of glucose as compared with controls. However, type 1 diabetic patients were still sensitive to the distal tubular antinatriuretic effect of insulin, as indicated by an increase in distal sodium reabsorption (95.5%±0.5% to 96.9%±0.4%;P<0.05) during insulin infusion compared with controls (95.5%±0.6% to 97.4%±0.3%;P<0.05). In control subjects insulin infusion was associated with 9% increases (P<0.05) in lithium clearance and in renal plasma flow, whereas no significant increases in lithium clearance and in renal plasma flow were observed in the type 1 diabetic patients. In both groups, the changes in renal plasma flow in response to insulin infusion were positively correlated with that in lithium clearance (r=0.80 andr=0.90, respectively;P<0.05−0.01). In conclusion, the present result demonstrates an intact distal tubular sodium retaining effect in conjunction with a blunted decrease in proximal tubular sodium reabsorption following insulin infusion, which could be the result of an impaired renal vasodilation in type 1 diabetes mellitus.

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Authors and Affiliations

  1. Department of Renal Medicine Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden

    P. Stenvinkel, A. Ottosson-Seeberger & A. Alvestrand

  2. Department of Internal Medicine, Huddinge University Hospital, S-14186, Huddinge, Sweden

    J. Bolinder

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  1. P. Stenvinkel
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  2. A. Ottosson-Seeberger
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  3. A. Alvestrand
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  4. J. Bolinder
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Stenvinkel, P., Ottosson-Seeberger, A., Alvestrand, A. et al. Effect of insulin on renal sodium handling and renal haemodynamics in insulin-dependent (type 1) diabetes mellitus patients. Acta Diabetol 32, 230–234 (1995). https://doi.org/10.1007/BF00576255

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  • DOI: https://doi.org/10.1007/BF00576255

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