Milrinone, a selective phosphodiesterase 3 inhibitor, stimulates lipolysis, endogenous glucose production, and insulin secretion.

In vivo effects of milrinone, a selective phosphodiesterase 3 (PDE-3) inhibitor, on plasma free fatty acids (FFA), glucose, and insulin levels were examined in alert rats. In dose response studies, intravenous injection of 1, 5 or 25 micromol/kg of milrinone provoked an immediate increase in plasma concentrations of FFA and insulin, while glucose levels rose only in response to the 5- and 25-micromol/kg doses. During euglycemic-hyperinsulinemic (approximately 450 pmol/L) clamps, intravenous injection of milrinone (25 micromol/kg) completely inhibited insulin suppression of lipolysis and of endogenous glucose production, while having no effect on insulin-stimulated glucose uptake (ISGU). To explore the reason why ISGU was not affected, we performed reverse-transcriptase polymerase chain reaction (RT-PCR) with RNA from skeletal muscle, fat, and liver. The results showed that PDE-3B mRNA was expressed in adipose tissue and liver, but it was not detected in skeletal muscle. We conclude that PDE-3 plays a major role in the inhibitory action of insulin on lipolysis in fat and on glucose production in liver and, in addition, seems to be involved in insulin secretion in pancreatic beta cells.