Insulin prevents glucose induced inhibition of angiotensin II-stimulated aldosterone secretion.

In humans with diabetes mellitus or in individuals given infusions of insulin or insulin plus glucose, plasma aldosterone levels have been reported to be suppressed. Whether insulin has a direct effect to suppress aldosterone secretion by the adrenal gland has not been established. The effect of insulin on glucose-induced inhibition of angiotensin II-stimulated aldosterone secretion was examined. The effect of glucose and insulin plus glucose on angiotensin II-stimulated aldosterone secretion was examined in isolated perfused canine adrenal glands. In the absence of insulin, 15.6 mM glucose decreased angiotensin II-stimulated aldosterone secretion by 35 +/- 7%, while in the presence of insulin the same glucose concentration had no significant effect on angiotensin II-stimulated aldosterone secretion. In contrast, insulin had no effect on NaCl-induced inhibition of angiotensin II-stimulated aldosterone secretion. Neither insulin alone nor saline vehicle affected angiotensin II-stimulated aldosterone secretion. These results (1) demonstrate that insulin can prevent inhibition of glucose-induced angiotensin II-stimulated aldosterone secretion, possibly by preventing a glucose-induced decrease in cell volume, and (2) suggest that the suppressed plasma level of aldosterone found in individuals with diabetes mellitus may in part be due to the direct effects of hyperglycemia on the adrenal gland secretion of aldosterone.