Summary
Forearm glucose uptake during a hyperglycaemic (10 mmol/l) glucose clamp was diminished
to 33% of the normal value (p=0.012) in six cirrhotic patients compared with matched
control subjects. Fasting insulin concentrations were significantly elevated in the
cirrhotic patients confirming insulin resistance which may have been induced by chronic
hyperinsulinaemia. The cirrhotic patients received one week of treatment with 50μg
octreotide subcutaneously three times daily which reduced pre-dose fasting insulin
levels from 26.2±7.9 to 18.1±6.2 mU/l p<0.005, and post dose levels to 7.0± 3.5 mU/l
p<0.005. However when the glucose clamp was repeated 20 hours after the last dose
of octreotide no change was detected in clamp glucose requirements, forearm glucose
uptake, or stimulated insulin secretion. It was concluded that one week of lowering
insulin levels does not reverse the insulin resistance of cirrhosis.
Key words
Cirrhosis - Insulin Resistance - Hyperinsulinaemia - Glucose Intolerance - Octreotide
- Forearm
