Intensive insulin treatment induces insulin resistance in diabetic rats by impairing glucose metabolism-related mechanisms in muscle and liver

J Endocrinol. 2011 Oct;211(1):55-64. doi: 10.1530/JOE-11-0105. Epub 2011 Jul 11.

Abstract

Insulin replacement is the only effective therapy to manage hyperglycemia in type 1 diabetes mellitus (T1DM). Nevertheless, intensive insulin therapy has inadvertently led to insulin resistance. This study investigates mechanisms involved in the insulin resistance induced by hyperinsulinization. Wistar rats were rendered diabetic by alloxan injection, and 2 weeks later received saline or different doses of neutral protamine Hagedorn insulin (1.5, 3, 6, and 9 U/day) over 7 days. Insulinopenic-untreated rats and 6U- and 9U-treated rats developed insulin resistance, whereas 3U-treated rats revealed the highest grade of insulin sensitivity, but did not achieve good glycemic control as 6U- and 9U-treated rats did. This insulin sensitivity profile was in agreement with glucose transporter 4 expression and translocation in skeletal muscle, and insulin signaling, phosphoenolpyruvate carboxykinase/glucose-6-phosphatase expression and glycogen storage in the liver. Under the expectation that insulin resistance develops in hyperinsulinized diabetic patients, we believe insulin sensitizer approaches should be considered in treating T1DM.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alloxan / adverse effects
  • Animals
  • Diabetes Mellitus, Experimental / chemically induced
  • Diabetes Mellitus, Experimental / drug therapy*
  • Diabetes Mellitus, Experimental / metabolism*
  • Disease Models, Animal
  • Dose-Response Relationship, Drug
  • Forkhead Transcription Factors / metabolism
  • Glucose / metabolism*
  • Glucose Transporter Type 4 / metabolism
  • Glucose-6-Phosphatase / metabolism
  • Glycogen / metabolism
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use*
  • Insulin Resistance / physiology*
  • Liver / metabolism*
  • Male
  • Muscle, Skeletal / metabolism*
  • Nerve Tissue Proteins / metabolism
  • Protein Serine-Threonine Kinases / metabolism
  • Rats
  • Rats, Wistar

Substances

  • Forkhead Transcription Factors
  • Glucose Transporter Type 4
  • Hypoglycemic Agents
  • Insulin
  • Nerve Tissue Proteins
  • Slc2a4 protein, rat
  • Foxo1 protein, rat
  • Alloxan
  • Glycogen
  • phosphoenolpyruvate carboxylase kinase
  • Protein Serine-Threonine Kinases
  • Glucose-6-Phosphatase
  • Glucose