Insulin sensitivity in alcoholics in a withdrawal state

. Insulin sensitivity in non‐diabetic alcoholics in a withdrawal state was investigated using a euglycaemic clamp technique on two occasions with an interval of 1 week. Insulin was infused at a rate of 40 mU m −2 min −1 ( n = 9) and 20 mU m −2 min −1 ( n = 9). Hepatic glucose production was estimated with tritiated glucose in six subjects. The fasting glucose level at the first examination, 5.1 ± 0.2 mmol l −1 exceeded that found at the second examination, 4.7 ± 0.1 mmol l −1 (P < 0.05), although the C‐peptide concentration was higher at the first examination (2.7 ± 0.3 vs. 1.6 ± 0.2 ng ml −1 : P < 0.001). Both glucose uptake (5.0 ± 0.6 vs 6.2 ± 0.7 mg kg −1 min −1 : P < 0.05) and tissue sensitivity (M/I; 0.08 ± 0.02 vs. 0.1 ± 0.02 mg kg −1 min −1 /mU l −1 ; P < 0.05) increased between the first and second euglycaemic clamp (40 mU m −2 min −1 ). At the low insulin infusion rate (20 mU m −2 min −1 ), the tissue sensitivity to insulin increased (0.09 ± 0.01 vs. 0.13 ± 0.02 mg kg −1 min −1 /mU l −1 ; P < 0.05). Hepatic glucose production did not change during the examination period (2.2 ± 0.2 vs. 2.3 ± 0.1 mg kg −1 min −1 ), neither was there a change in the suppression of hepatic glucose output during hyperinsulinaemia (40 mU m −2 min −1 ). Our findings indicate that, in non‐diabetic alcoholics, insulin sensitivity in peripheral tissues is decreased during the early part of a withdrawal period.