TY - JOUR
T1 - Increased insulin secretion in puberty
T2 - A compensatory response to reductions in insulin sensitivity
AU - Caprio, Sonia
AU - Plewe, Gerd
AU - Diamond, Michael P.
AU - Simonson, Donald C.
AU - Boulware, Susan D.
AU - Sherwin, Robert S.
AU - Tamborlane, William V.
N1 - Funding Information:
Although studies with the euglycemic insulin clamp technique suggest that insulin sensitivity is reduced in normal children during puberty, L,z the effect of this apparent insulin resistance on insulin secretion has not been established. Elevated plasma insulin levels after glucose inges- Supported by grants No. RR00125 and No. AM20495 from the National Institutes of Health and by grants from the Juvenile Diabetes Foundation International and Squibb-Novo Laboratories, Princeton, N.J. Dr. Caprio is the recipient of a postdoctoral fellowship from the Juvenile Diabetes Foundation International, and Dr. Diamond is the recipient of a Clinical Associate Physician Award from the General Clinical Research Center. Submitted for publication Oct. 10, 1988; accepted Dec. 21, 1988. Reprint requests: Sonia Caprio, MD, Department of Pediatrics, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510. *Now at Joslin Diabetes Center, Boston.
PY - 1989/6
Y1 - 1989/6
N2 - Recent studies have suggested that insulin action is reduced during puberty in normal children. To determine whether such resistance leads to excessive insulin secretion, we used the hyperglycemic clamp technique to produce a standard hyperglycemic stimulus (125 mg/dl above fasting levels for 120 minutes) in 9 preadolescent and 14 adolescent healthy children and in 14 normal adults. Fasting plasma insulin and C-peptide concentrations were higher in adolescents than in preadolescents and adults (p≤0.02). Despite identical glucose increments during the glucose clamp procedure, both first- and second-phase plasma insulin and C-peptide responses were also markedly greater in adolescents than in preadolescents or adults (p<0.01 vs. other groups). Despite sharply increased insulin responses in adolescents, the amount of exogenous glucose required to maintain hyperglycemia was similar in all three groups. Insulin responses in the children were directly correlated with fasting plasma levels of insulin-like growth factor I (r=0.60 to 0.70, p<0.01). We conclude that glucose-stimulated insulin secretion is normally increased during puberty, a response that may compensate for puberty-induced defects in insulin sensitivity.
AB - Recent studies have suggested that insulin action is reduced during puberty in normal children. To determine whether such resistance leads to excessive insulin secretion, we used the hyperglycemic clamp technique to produce a standard hyperglycemic stimulus (125 mg/dl above fasting levels for 120 minutes) in 9 preadolescent and 14 adolescent healthy children and in 14 normal adults. Fasting plasma insulin and C-peptide concentrations were higher in adolescents than in preadolescents and adults (p≤0.02). Despite identical glucose increments during the glucose clamp procedure, both first- and second-phase plasma insulin and C-peptide responses were also markedly greater in adolescents than in preadolescents or adults (p<0.01 vs. other groups). Despite sharply increased insulin responses in adolescents, the amount of exogenous glucose required to maintain hyperglycemia was similar in all three groups. Insulin responses in the children were directly correlated with fasting plasma levels of insulin-like growth factor I (r=0.60 to 0.70, p<0.01). We conclude that glucose-stimulated insulin secretion is normally increased during puberty, a response that may compensate for puberty-induced defects in insulin sensitivity.
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U2 - 10.1016/S0022-3476(89)80438-X
DO - 10.1016/S0022-3476(89)80438-X
M3 - Article
C2 - 2524556
AN - SCOPUS:0024364978
SN - 0022-3476
VL - 114
SP - 963
EP - 967
JO - The Journal of Pediatrics
JF - The Journal of Pediatrics
IS - 6
ER -