Glucose homeostasis during prolonged suppression of glucagon and insulin secretion by somatostatin

R. S. Sherwin, R. Hendler, R. DeFronzo, J. Wahren, P. Felic

Research output: Contribution to journalArticle

76 Scopus citations

Abstract

Somatostatin was infused for 5-8 hr into five normal men and eleven normal, conscious dogs. This infusion resulted in a persistent decline in plasma glucagon (40-60%) and insulin (30-45%). Plasma glucose fell 15-25% during the initial 1-2 hr, but subsequently rose to hyperglycemic levels (130-155 mg/100 ml) by 3-6 hr, despite persistent hypoglucagonemia. Glucose production initially declined by 40-50%, but later rose to levels 15-20% above basal rates while peripheral glucose utilization fell to levels 20-30% below basal, thereby accounting for hyperglycemia. Infusion of exogenous insulin so as to restore plasma insulin to preinfusion values or cessation of the somatostatin infusion with restoration of endogenous insulin secretion resulted in a prompt reduction of plasma glucose to baseline values. Prevention of the initial somatostatin induced hypoglycemic response by intravenous infusion of glucose failed to prevent the delayed hyperglycemia. We conclude that somatostatin causes only transient hypoglycemia in normal subjects and that hyperglycemia eventually develops as a consequence of insulin deficiency. These data indicate that basal glucagon secretion is not essential for the development of fasting hyperglycemia and support the conclusion that insulin deficiency rather than glucagon excess is the primary factor responsible for abnormal glucose homeostasis in the diabetic.

Original languageEnglish (US)
Pages (from-to)348-352
Number of pages5
JournalProceedings of the National Academy of Sciences of the United States of America
Volume74
Issue number1
DOIs
StatePublished - Oct 3 1977
Externally publishedYes

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