Comparison of insulins detemir and glargine: effects on glucose disposal, hepatic glucose release and the central nervous system.

Moore MC, Smith MS, Turney MK, Boysen S, Williams PE
Diabetes Obes Metab. 2011 13 (9): 832-40

PMID: 21554521 · PMCID: PMC3144987 · DOI:10.1111/j.1463-1326.2011.01418.x

AIMS - The effects of insulins detemir (Det) and glargine (Glar) on endogenous glucose production (EGP) and net hepatic glucose output (NHGO) were compared.

METHODS - Arteriovenous difference and tracer ([3-(3) H]glucose) techniques were employed during a two-step hyperinsulinemic euglycaemic clamp in conscious dogs (6 groups, n = 5-6/group). After equilibration and basal sampling (0-120 min), somatostatin was infused and basal glucagon was replaced intraportally. Det or Glar was infused via portal vein (Po), peripheral vein (IV), or bilateral carotid and vertebral arteries (H) at 0.1 and 0.3 mU/kg/min (low Insulin; Glar vs. Det, respectively, 120-420 min) and 4× the low insulin rate (high insulin; 420-540 min).

RESULTS - NHGO and EGP were suppressed and glucose R(d) and infusion rate were stimulated similarly by Det and Glar at both Low and high insulin with each infusion route. Non-esterified fatty acid (NEFA) concentrations during low insulin were 202 ± 37 versus 323 ± 75 µM in DetPo and GlarPo (p < 0.05) and 125 ± 39 versus 263 ± 48 µM in DetIV and GlarIV, respectively (p < 0.05). In DetH versus GlarH, pAkt/Akt (1.7 ± 0.2 vs. 1.0 ± 0.2) and pSTAT3/STAT3 (1.4 ± 0.2 vs. 1.0 ± 0.1) were significantly increased in the liver but not in the hypothalamus.

CONCLUSIONS - Det and Glar have similar net effects on acute regulation of hepatic glucose metabolism in vivo regardless of delivery route. Portal and IV detemir delivery reduces circulating NEFA to a greater extent than glargine, and head detemir infusion enhances molecular signalling in the liver. These findings indicate a need for further examination of Det's central and hepatic effects.

© 2011 Blackwell Publishing Ltd.

MeSH Terms (13)

Animals Blood Glucose Central Nervous System Diabetes Mellitus, Experimental Diabetes Mellitus, Type 1 Dogs Glucose Clamp Technique Hypoglycemic Agents Insulin Insulin, Long-Acting Insulin Detemir Insulin Glargine Liver

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