Fasting plasma insulin concentrations

Thomas, B.J., Jarrett, R., Keen, H., Ruskin, H., 1981. Relation of habitual diet to fasting plasma insulin concentration and the insulin response to oral glucose. Human Nutrition. Clinical Nutrition 36, 49-56. 

Laws A, King AC, Haskell WL, et al. Relation of fasting Plasma insulin concentration to HDL-cholesterol and triglyceride concentration in men. Arteriosclerosis and Thrombosis 1991 11 1636-1642. 

Insulin For patients stabilized on insulin, continue the insulin dose upon initiation of rosiglitazone therapy. Dose rosiglitazone at 4 mg daily. Doses greater than 4 mg daily in combination with insulin are not currently indicated. It is recommended that the insulin dose be decreased 10% to 25% if the patient reports hypoglycemia or if fasting plasma glucose concentrations decrease to less than 100 mg/dL. 

In a double-blind, randomized, crossover study in 10 healthy subjects, subcutaneous glucagon-like peptide-1 after a 16-hour fast caused a near five-fold rise in plasma insulin concentration and circulating plasma glucose concentrations fell below the reference range in all subjects... 

In a 6-month, multinational, open, parallel-group comparison of insulin detemir and protamine zinc insulin in 448 patients with type 1 diabetes, the two treatments produced comparable HbAlc concentrations and fasting plasma glucose concentrations with less within-subject variation in fasting blood glucose with insulin detemir (4). The risk of hypoglycemia was 22% lower with insulin detemir and 34% lower for nocturnal hypoglycemia. 

In 619 patients with type 1 diabetes treated with protamine zinc insulin and insulin lispro, randomized to once-daily insulin glargine or to once-daily or twice-daily protamine zinc insulin for 16 weeks in an open study, there was no difference in the frequency of hypoglycemic episodes, severe hypoglycemia, or HbAic (25). Fasting plasma glucose concentrations were lower with insulin glargine. 

In an open study in seven men and four women taking olanzapine (mean daily dose 12 mg and mean treatment duration 23 months), although the mean fasting triglyceride concentrations and mean fasting plasma glucose concentrations were similar to those found in the previous study, the mean fasting insulin concentrations were lower (143 pmol/1 versus 228 pmol/1), and four of the subjects had hyperinsulinemia, compared with ten in the other study (869). However, the small sample sizes precluded any clear conclusions. 

Fig. 9.6 (A) Hemoglobin A1 c (HbAlc) levels in the inhaled and subcutaneous (SC) insulin groups. (B) Mean change in fasting plasma glucose concentration in the inhaled and SC insulin groups. (Reproduced with permission from [60]).

First-line therapy includes nutritional and exercise interventions for all women, and caloric restrictions for obese women. If nutritional intervention fails to achieve fasting plasma glucose levels less than or equal to 105 mg/dL, 1-hour post-prandial plasma glucose concentrations less than or equal to 155 mg/dL, or 2-hour postprandial levels less than or equal to 130 mg/dL, then therapy with recombinant human insulin should be instituted glyburide may be considered after 11 weeks of gestation. 

Several other studies also showed an association between IMCL accumulation and insulin resistance, however, there are also contradictory reports Krssak et al. studied a group of 23 normal weight non-diabetic adults without family history of diabetes and found a significant negative correlation between IMCL of soleus muscle and insulin sensitivity, but no relation between IMCL and BMI, age, and fasting plasma concentrations of triglycerides. 

MR examinations followed after the first (24 h), third (72 h) and fifth (120 h) day of fasting. Blood samples for measurements of plasma FFAs, glucose, and insulin concentrations were taken parallel to each MRS examination. 

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