Rates and tissue sites of noninsulin- and insulin-mediated glucose uptake in diabetic rats.

The purpose of the present study was to determine whether streptozotocin-induced diabetes alters the rates and tissue distribution of insulin-mediated glucose uptake (IMGU) and noninsulin-mediated glucose uptake (NIMGU). In vivo glucose disposal was assessed using the tracer [U-14C]-2-deoxyglucose technique in chronically catheterized conscious rats. For nondiabetic animals, rates of NIMGU were determined during severe insulinopenia (less than 5 microU/ml), induced by the infusion of somatostatin, under both euglycemic (6 mM) and hyperglycemic (17 mM) conditions. In diabetic rats, in which a severe insulin deficiency already existed, NIMGU was determined under basal hyperglycemic conditions and during euglycemic conditions produced by inhibiting hepatic glucose output. IMGU was determined in both groups using the euglycemichyperinsulinemic clamp technique. Glucose uptake was consistently higher (50-280%) in all tissues removed from diabetic rats under basal conditions, compared with tissues from control animals in the basal state. When control animals were rendered insulinopenic, glucose uptake by the skeletal muscle, heart, and diaphragm was reduced 30-60%, indicating that the uptake by these tissues occurred by both insulin- and noninsulin-mediated mechanisms. Glucose disposal by the other tissues sampled was entirely due to NIMGU under basal conditions. When blood glucose levels were elevated from 6 to 17 mM in control animals, NIMGU increased in all tissues (60-280%) except the brain. Rates of NIMGU were essentially identical between control and diabetic animals, under either euglycemic or hyperglycemic conditions, when glucose uptake was determined under the same steady-state plasma glucose levels. In contrast to the normal rate of NIMGU by muscle, IMGU by the skeletal muscle and heart from diabetic rats were reduced under mild hyperinsulinemic conditions (100 microU/ml), compared with control animals. Furthermore, in response to a maximal, stimulating dose of insulin (500 microU/ml), IMGU was impaired in the diaphragm, liver, lung, spleen, skin, and kidney removed from diabetic animals. These results indicate that the majority of glucose disposal under basal postabsorptive conditions occurs by NIMGU in both control and diabetic rats. Furthermore, while IMGU was selectively impaired in this model of insulin-dependent diabetes, the rates and tissue distribution of NIMGU were unaltered when glucose uptake was determined under similar plasma glucose levels.