Myocardial glucose uptake evaluated by positron emission tomography and fluorodeoxyglucose during hyperglycemic clamp in IDDM patients : role of free fatty acid and insulin levels

• Published in: Diabetes (New York, N.Y.) Vol. 44; no. 5; pp. 537 - 542
• Main Authors: MONTI, L. D, LUCIGNANI, G, LANDONI, C, MORESCO, R. M, PIATTI, P, STEFANI, I, POZZA, G, FAZIO, F
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-05-1995
• Subjects: Adult; Biological and medical sciences; Biological Transport, Active; Deoxyglucose - analogs & derivatives; Deoxyglucose - pharmacokinetics; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - metabolism; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fat Emulsions, Intravenous - administration & dosage; Fatty Acids, Nonesterified - blood; Fluorodeoxyglucose F18; Glucose - metabolism; Glucose Clamp Technique; Humans; Hypolipidemic Agents - administration & dosage; Insulin - administration & dosage; Insulin - blood; Male; Measurement; Medical sciences; Myocardium - metabolism; PET imaging; Positron emission tomography; Pyrazines - administration & dosage; Somatostatin - administration & dosage; Tomography, Emission-Computed; Type 1 diabetes; Endocrinopathy; Human; Immunopathology; Hyperglycemia; Insulin dependent diabetes; Myocardium; Autoimmune disease; Free fatty acid; Glucose; Metabolism; Insulin
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/diab.44.5.537

Myocardial and whole-body glucose metabolism was assessed in 19 insulin-dependent diabetes mellitus (IDDM) patients. A hyperglycemic clamp was performed 1) in the absence of insulin at free fatty acid (FFA) levels of 1.0 mmol/l (test 1); 2) in the absence of insulin at low FFA levels (0.1 mmol/l) by means of a lipid-lowering drug, acipimox (test 2); 3) during insulin infusion to achieve systemic levels of 400 pmol/l and FFA levels of 0.1 mmol/l (test 3); and 4) at the insulin levels of test 3 but increasing FFA to 1.0 mmol/l by means of heparin and intralipid infusion (test 4). Myocardial glucose uptake was measured by positron emission tomography (PET) and 2-[18F]fluoro-2-deoxy-D-glucose. Whole-body glucose uptake was measured in the four conditions by the glucose infusion rate during the PET scanning period. Myocardial glucose uptakes were 40.3 +/- 18.0, 395.5 +/- 139.6, 852.2 +/- 99.1, and 1,388.4 +/- 199.1 mumol.kg tissue-1.min-1 (mean +/- SD) and whole-body glucose uptakes were 10.1 +/- 2.3, 10.1 +/- 3.4, 42.8 +/- 5.8, and 30.5 +/- 5.6 mumol.kg body wt-1.min-1 during tests 1, 2, 3, and 4, respectively. Thus, in IDDM patients without coronary artery disease under the condition of hyperglycemia, an increase of myocardial glucose uptake was obtained either by lowering of FFA levels during hypoinsulinemia or by an increase in FFA levels during hyperinsulinemia. In both conditions no significant changes of whole-body glucose uptake were demonstrated.