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Insulin infusion normalizes fasting and post‐prandial albumin and fibrinogen synthesis in Type 1 diabetes mellitus
Author(s) -
Bruttomesso D.,
Iori E.,
Kiwanuka E.,
Zanetti M.,
Pianta A.,
Vettore M.,
Tiengo A.,
Tessari P.
Publication year - 2001
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2001.00606.x
Subject(s) - medicine , fibrinogen , endocrinology , insulin , albumin , type 1 diabetes , diabetes mellitus , postprandial , meal
Aims The effect of metabolic control on hepatic synthesis of plasma proteins in Type 1 diabetes mellitus (T1DM), in the post‐absorptive and post‐prandial state, is not known. Methods We measured fractional synthetic rates (FSR) of albumin and fibrinogen in six insulin‐infused T1DM patients and in five to nine control subjects, before and for approx. 4 h after a mixed liquid meal. Phenylalanine tracer precursor/product relationships and steady‐state conditions were used. In the post‐absorptive state, patients were studied in near euglycaemic conditions after an overnight intravenous insulin infusion. During the meal (approx. 11 kcal/kg), the insulin infusion rate was increased to maintain plasma glucose concentrations below approx. 10 mmol/l. Results Post‐absorptive FSR of albumin (5.7 ± 0.6%/day) and fibrinogen (11.3 ± 0.6%/day) in T1DM were similar to control values (6.4 ± 0.9 and 13.1 ± 1.1, respectively). After the meal, albumin FSR increased ( P = 0.0032 by anova ) in both groups (T1DM, to 14.4 ± 2.7%/day; controls, to 18.2 ± 3.7%/day). Fibrinogen FSR also increased ( P = 0.0048 by anova ) in both the T1DM (to 18.2 ± 2.6) and the control subjects (to 27.3 ± 6.2). There was no difference between T1DM and control subjects in the post‐prandial FSR of both proteins. Conclusions Albumin and fibrinogen FSR in T1DM can be maintained within near‐normal ranges by insulin infusion under post‐absorptive and post‐prandial conditions. Diabet. Med. 18, 915–920 (2001)