Premium
Nasal insulin administration does not affect hepatic glucose production at systemic fasting insulin levels
Author(s) -
Plomgaard Peter,
Hansen Jakob S.,
Ingerslev Bodil,
Clemmesen Jens O.,
Secher Niels H.,
van Hall Gerrit,
Fritsche Andreas,
Weigert Cora,
Lehmann Rainer,
Häring HansUlrich,
Heni Martin
Publication year - 2019
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13615
Subject(s) - insulin , medicine , endocrinology , endogeny , glucose uptake
Aims To evaluate the effects of brain insulin on endogenous glucose production in fasting humans, with a focus on hepatic glucose release by performing a randomized, placebo‐controlled, blinded, crossover experiment. Materials and methods On two separate days, 2 H 2 ‐glucose was infused to nine healthy lean men, and blood was sampled from the hepatic vein and a radial artery. On day 1, participants received 160 U human insulin through nasal spray, and on day 2 they received placebo spray, together with an intravenous insulin bolus to mimic spillover of nasal insulin to the circulation. Hepatic glucose fluxes and endogenous glucose production were calculated. Results Plasma insulin concentrations were similar on the two study days, and no differences in whole‐body endogenous glucose production or hepato‐splanchnic glucose turnover were detected. Conclusions Nasal administration of insulin does not influence whole‐body or hepatic glucose production in fasting humans. By contrast, pharmacological delivery of insulin to the brain might modulate insulin effectiveness in glucose‐producing tissue when circulating insulin levels are elevated; therefore, the metabolic consequences of brain insulin action appear to be dependent on metabolic prandial status.